Abstract: [Objective] To evaluate the value of CT/MRI fusion imaging in the diagnosis of traumatic cauda equina dural herniation in lumbar burst fractures, and its significance in determining the surgical technique. [Methods] A retrospective study was conducted on 28 patients who received surgical treatment for lumbar burst fracture combined with laminar fracture and cauda equina nerve injury in Zhengzhou Orthopaedic Hospital from June 2016 to June 2020. As thin-slice CT and MRI were performed routinely before operation, and Medraw software was used to achieve rapid registration fusion of CT and MRI 3D images. Intraoperative exploration was conducted to verify accuracy of imaging diagnosis of dural cauda equina herniation, and carried out corresponding individualized surgical treatment. [Results] On the preoperative CT/MRI fusion imaging of 28 patients, dural and cauda equina nerve herniation were found in 23 cases, accounting for 82.1%, which presented cauda equina nerve embedded in the lamina fracture gap. The intraoperative findings were completely consistent with the imaging findings, and the diagnostic accuracy of imaging was 100.0%. All patients underwent successful surgery and were followed up for 12 to 26 months (18.5±2.3). Compared with those before surgery, the VAS scores [(8.3±0.7), (2.2±0.3), P＜0.001], ODI score [(38.5± 4.3), (7.2±1.3), P＜0.001], JOA score [(12.8±0.8), (25.6±1.4), P＜0.001], and ASIA nerve function scale [A/B/C/D/E, (0/18/7/3/0), (0/0/3/5/ 20), P＜0.001] significantly improved at the last follow-up. [Conclusion] The CT/MRI fusion imaging taken before surgery for patients with lumbar fracture complicated with neurological symptoms does intuitively determine the position relationship between the dura cauda equina and the posterior lamina fractured, accurately diagnose traumatic dura cauda equina herniation, provide an important reference for accurate surgery, and obtain satisfactory clinical results.