Diário da Espinha

A Transdural Approach for Lower Lumbar Burst Fractures. A Novel(Kotil) Technical Note

Abstract

Kadir Kotil and Selim Kayaci

The treatment of surgical procedure of lower lumbar burst fractures is challenged. The optimal method remains controversial. To assess the usefulness and safety of a novel both decompression and reconstructive procedures known as transdural approaches of lower lumbar spine burst fracture. For this reason, we presented the results of a trans-dural approach which is a new technique. We presented the reconstruction and dural repairing results of 5 cases that were operated on between the years 1995-2011 due to lower lumbar burst fractures with a trans-dural surgical technique. Cases were chosen for this technique according to the presence of lamina fractures displayed on tomography (CT) and lumbar (MRI). Intra canal fragments, lamina fractures were determined. The postoperative opening of the spinal canal, the loss of height of the middle and anterior column and the postoperative fusion results were investigated. The surgical results of the cases were classified according to the Odom’s criteria. No instances of neurological deterioration and instrument failure occurred and no complications were noted with the use of this technique. All five patients had neurological function recovery at the most recent follow-up visit. In conclusion, this reported new surgical approach is an efficient and safe method for the treatment of traumatic lower lumbar burst fractures.