Dural tears associated with lumbar burst fractures.

A retrospective review of 817 spinal fracture patients revealed a 7.7% (20 of 258) incidence of dural tears in surgically treated patients. Dural tears were most common in the lumbar burst fractures (10 of 85). Twenty-five percent of patients with lumbar spine burst fractures and a neurologic deficit had a dural tear requiring repair. Eighty-six percent of patients with lumbar burst injuries and dural tears had a neurologic deficit. An initial posterior approach with inspection of the dura and stabilization of the fracture is recommended when treating lumbar burst fractures with a neural deficit.