cauda equina fracture repair

Treatment of diseases: chest and lumbar burst fractures Indication The repair of the horsetail fracture is suitable for the complete dislocation of the upper lumbar spine and the complete interception of the suspected horsetail fracture. The fresh injury is operated within a few days. The delay is difficult to handle due to adhesion at the ponytail break. Contraindications In addition to the neurological examination to understand the damage of the cauda equina and nerve roots, a good positive lateral radiograph and necessary CT examination to determine whether there is a burst fracture, displacement of the fracture block, degree of dislocation of the front or side, No joint fractures, etc. Surgical procedure 1. Posterior median incision Exposure and reduction methods are associated with dislocation of fresh fractures. After the reduction, the dislocated vertebral lamina was removed and the lower vertebrae were removed. The dura mater was exposed 2 to 3 cm, and the dural sac was incised. 2. Repair of broken horsetail The intradural hemorrhage was removed and the horsetail end was observed. When the lumbar spine is completely dislocated, the upper ponytail is neatly traversed due to the transverse force, and is suitable for suturing. At the level of the waist 2, the horsetail is bundled, and the hemorrhage is gently wiped off with the brain cotton piece. If the broken end is neat, it is not necessary to remove a section to avoid irregular cutting and nerve defects. There are many fiber bundles in the broken end, the first half is slightly thicker, the second half is the sensory bundle, and the second half is the sensory bundle. The soft film is pulled by the non-toothed tip tweezers to make the two ends meet, generally no tension, 7-9 -0 fine nylon thread sutures the soft film of the coarse fiber bundle as an internal fixation, and one needle can be fixed on each side. Stitch the dura mater. 3. Internal fixation and integration Same as "Lumbar fracture and dislocation reduction and fixation". 4. Close the incision Separate layer by layer, the drainage tube can be placed.

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