title: Posterior transthecal approach for repair of cauda equina fibers and ventral dural laceration in lumbar burst fracture: a novel surgical technique.
abstract: METHODS
  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.
  
  
  BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  4.
authors.affiliation: Department of Surgery, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Abel Po-Hao
authors.initials: AP
authors.lastname: Huang
authors.forename: Chien-Min
authors.initials: CM
authors.lastname: Chen
authors.forename: Hong-Shiee
authors.initials: HS
authors.lastname: Lai
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Chou
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Lu
authors.forename: Lu-Ting
authors.initials: LT
authors.lastname: Kuo
authors.forename: Ho-Yu
authors.initials: HY
authors.lastname: Chuang
authors.forename: Jui-Chang
authors.initials: JC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D002420:Cauda Equina / Q000601:surgery*; D004388:Dura Mater / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000601:surgery*; D016103:Spinal Fractures / Q000175:diagnosis / Q000601:surgery*