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| KANG Hui,CAI Xianhua,XU Feng.The clinical outcome of minimally invasive transforaminal lumbar interbody fusion under Quadrant system for recurent lumbar disc herniation[J].Chinese Journal of Spine and Spinal Cord,2013,(3):198-203. |
| The clinical outcome of minimally invasive transforaminal lumbar interbody fusion under Quadrant system for recurent lumbar disc herniation |
| Received:October 22, 2012 Revised:December 25, 2012 |
| English Keywords:Recurrent lumbar disc herniation Transforaminal lumbar interbody fusion Quadrant system Effect |
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| 【Abstract】 Objectives: To investigate the clinical outcomes of minimally invasive transforaminal lumbar interbody fusion(TLIF) under Quadrant system for recurrent lumbar disc herniation. Methods: From February 2007 to March 2010, a total of 35 cases suffering from recurrent lumbar disc herniation and undergoing surgical intervention was retrospectively analyzed. There were 22 males and 13 females, with a mean age of 53.2 years(range, 33-62 years). A total of 39 segments was involved, including L4/5 in 18 cases, L5/S1 in 13 cases, L4/5 and L5/S1 in 4 cases. The interval between first operation and recurrence was 8-70 months(mean, 38.2 months). 35 cases underwent bilateral minimally invasive TLIF under Quadrant system. VAS score system was used to evaluate back pain at pre- and post- operation(3d and 12 months). JOA(29) score system was used to evaluate the pre- and post- operative(12 months) score and improvement rate, which was used to evaluate clinical effects. Results: The operation time was 105-210min(mean, 145min), blood loss was 210-580ml(mean, 335ml), drainage was 90-230ml(mean, 140ml). No leakage of cerebrospinal fluid or nerve root injury was noted during the operation. VAS score was 7.63±0.81 at preoperation, 2.46±0.92 at 3d postoperation, 1.14±0.69 at 12 months postoperation, which showed statistical significance between preoperative and 3d postoperation(P<0.05) as well as between 3d postoperation and 12 months postoperation(P<0.05). The mean score of JOA was 14.26±1.36 at preoperation, 25.06±1.19 at 12 months postoperation, which showed statistical significance between preoperation and 12 months postoperation(P<0.05). The improvement rate was 41%-90%(mean, 78%) at 12 months postoperation. According to the rate of clinical improvement, there were 21 excellent, 10 good and 4 fair. All patients were followed up for 19-41 months(mean, 20 months), and all cases got bony fusion with the fusion time of 6-12 months(mean, 9.5 months). No instrument failure was noted. Conclusions: Minimally invasive TLIF under Quadrant system can achieve reliable clinical results for recurrent lumbar disc herniation. |
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