摘要
Abstract
Objective To explore the clinical outcome of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of recurrent intervertebral disc hemiation.Methods 25 recurrent intervertebral disc herniation patients who received MIS-TLIF treatment from March 2011 to March 2014 were enrolled in this study.There were 15 males and 10 females,with an average age of 51.4 years (33 to 71 years).Among them.13 patients underwent L4/5 fusion,12 patients underwent L5/S1 fusion;14 patients received posterior approach discectomy previously,11 patients received endoscopic discectomy previously,the average time of recurrence was 24.4 months (7 to 72 months).The intraoperative blood loss,operative time,and perioperative complications were recorded.Visual analogue scale (VAS)and Oswestry disability index (ODI) score were used to evaluate the clinical outcome and lumbar X-ray was used to observe the intervertebral fusion at the final follow-up.Results The average follow-up time was 16.2 months (12 to 24 months),the average intraoperative blood loss was (310±50) mL,the average postoperative drainage volume was (85± 15) mL.The preoperative and final follow-up VAS scores of back pain were (6.8±2.4) and (0.9±0.2) respectively,the preoperative and final follow-up VAS scores of leg pain were (7.6±1.2) and (1.1±0.3) respectively,the difference between the final follow-up and preoperative VAS scores was significant (t=12.25,t=26.3,P＜0.05).The preoperative and the final follow-up ODI score were (44.2±4.7) and (12.3±1.4) respectively,and the difference was significant (t=32.58,P＜0.05).All patients demonstrated evidence of fusionat at the final follow-up,and there was no internal fixation loosening or fracture.Nerve root injury was occurred in 1 case,dural tear was observed in 1 case,contralateral lower limb pain was occurred in 1 case.Conclusion For recurrent intervertebral disc herniation,MIS-TLIF is a safe and effective treatment method in short term,and it still needs further study with large sample and long time follow-up.关键词
腰椎间盘突出症/微创/融合Key words
Lumbar disc disease/Minimally invasive/Fusion分类
医药卫生
