Posterior transthecal approach for repair of cauda equina fibers and ventral dural laceration in lumbar burst fracture: A novel surgical technique
Journal
Spine
Journal Volume
38
Journal Issue
18
Pages
E1156-E1161
Date Issued
2013
Author(s)
Chen C.-M.
Chou C.-C.
Lu D.C.
Chuang H.-Y.
Abstract
STUDY DESIGN.: Retrospective descriptive study of an innovative surgical technique for patients with thoracolumbar fracture. OBJECTIVE.: To describe the transthecal approach for patients with thoracolumbar fracture and demonstrate its safety and effectiveness. SUMMARY OF BACKGROUND DATA.: The goals of surgery in patients with thoracolumbar fracture include neural decompression, re-establishing stability, reduction of deformity, and repair of dural laceration and the damaged neural elements. The traditional posterior approach may only accomplish the former 3 goals. METHODS.: Simply opening the dura during the traditional posterior approach enables accomplishment of all the aforementioned goals, which would not be possible through an anterior or posterior approach alone. RESULTS.: We have successfully performed the transthecal approach in 5 patients with thoracolumbar burst fracture with cauda equina fiber injury. Neural decompression, re-establishing stability, reduction of deformity, and repair of dural laceration and the damaged cauda equina fiber were all achieved in these patients. No complications were noted. CONCLUSION.: The transthecal approach can be applied to patients with thoracolumbar burst fracture to achieve neural decompression, re-establishing stability, reduction of deformity, and repair of dural laceration and the damaged cauda equina fiber. This approach may be an alternative to combined (circumferential) surgery. ? 2013 Lippincott Williams & Wilkins.
SDGs
Other Subjects
fibrin glue; polypropylene; abdominal pain; adult; anorectal pressure; arthrodesis; article; Barthel index; case report; cauda equina syndrome; computer assisted tomography; consciousness level; decompression surgery; decubitus; female; green stick fracture; hematocrit; human; kidney hemorrhage; kidney injury; laceration; laminectomy; limb weakness; liquorrhea; liver injury; lumbar burst fracture; nephrectomy; nuclear magnetic resonance imaging; paresthesia; patient safety; pneumonia; posterior transthecal approach; priority journal; retroperitoneal hematoma; spine surgery; surgical approach; surgical technique; thoracolumbar fracture; traffic accident; transpedicular screw; ventral dural laceration; wound infection; Adult; Cauda Equina; Dura Mater; Female; Follow-Up Studies; Humans; Lumbar Vertebrae; Male; Middle Aged; Neurosurgical Procedures; Retrospective Studies; Spinal Cord Injuries; Spinal Fractures
Type
journal article