Li Bing, Hu Zhaohui, Zhuo Xianglong
Department of Orthopaedics, the Fifth Affiliated Hospital of Guangxi Medical University, People's Hospital of Liuzhou City, Liuzhou Guangxi, 545001, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Aug;22(8):914-7.
To discuss the key issues in the diagnosis and treatment of degenerative disc disease and the therapeutic effect of transforaminal lumbar interbody fusion on it.
From September 2004 to August 2006, 15 cases of degenerative disc disease were treated by transforaminal lumbar interbody fusion, including 8 males and 7 females with the age of 33-46 years. All cases were single-level degenerative disc diseases, including 1 case of L3,4, 8 cases of L4,5 and 6 cases of L5, S1. The course of the disease was 2 -10 years. Preoperatively, the score of visual analogue scale (VAS) was 8.9 +/- 1.8 and the score of Oswestry disability index (ODI) was 51.4 +/- 8.3. All patients had received normal conventional treatment for at least 3 months and had no therapeutic effect before operation.
The operation time was 120-180 minutes (150 minutes on average) and the intra-operative blood loss was 200-500 mL (360 mL on average). There was no severe complication, except that the muscle tone of anterior tibia in one case decreased to the third level, which recovered to the 5(-) level 3 months after operation. A total of 15 cases were followed up for 12-24 months (18 months on average). All patients got interbody bony fusion 12 months after operation with the fusion rate of 100%. Postoperatively, the score of VAS was 2.8 +/- 1.6 and the score of ODI was 19.1 +/- 3.2, indicating there were significant difference in comparison with postoperative ones (P < 0.05). The improvement rates of postoperative VAS and ODI were 61.8% +/- 7.3% and 64.3% +/- 5.5%, respectively. For the therapeutic effect, 6 cases were regarded as excellent, 8 good, 1 fair, and the choiceness rate was 93.3%. All patients resumed their jobs and normal lives.
Transforaminal lumbar interbody fusion is effective for the treatment of lumbar degenerative disc disease, but the indications for operation must be strictly defined.
探讨腰椎间盘退变疾病诊断与治疗中的关键问题以及经椎间孔腰椎椎体间融合术对其的治疗效果。
2004年9月至2006年8月，对15例腰椎间盘退变疾病患者行经椎间孔腰椎椎体间融合术治疗，其中男8例，女7例，年龄33 - 46岁。所有病例均为单节段腰椎间盘退变疾病，其中L3、4节段1例，L4、5节段8例，L5、S1节段6例。病程2 - 10年。术前视觉模拟评分（VAS）为8.9±1.8分，Oswestry功能障碍指数（ODI）为51.4±8.3分。所有患者术前均接受正规保守治疗至少3个月且无效。
手术时间120 - 180分钟（平均150分钟），术中出血量200 - 500毫升（平均360毫升）。除1例患者胫前肌肌力下降至Ⅲ级，术后3个月恢复至Ⅴ-级外，无严重并发症发生。15例患者均获随访，随访时间12 - 24个月（平均18个月）。所有患者术后12个月均获得椎间骨性融合，融合率100%。术后VAS评分为2.8±1.6分，ODI评分为19.1±3.2分，与术前比较差异有统计学意义（P < 0.05）。术后VAS及ODI改善率分别为61.8%±7.3%和64.3%±5.5%。治疗效果：优6例，良8例，可1例，优良率93.3%。所有患者均恢复工作及正常生活。
经椎间孔腰椎椎体间融合术治疗腰椎间盘退变疾病疗效确切，但手术适应证必须严格掌握。
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