[Treatment of far lateral lumbar disc herniation with unilateral pedicle screw fixation and intervertebral body fusion after decompression].

OBJECTIVE

To investigate the surgical outcomes of unilateral lumbar pedicle screw fixation and intervertebral body fusion in treating far lateral lumber disc herniation.

METHODS

From June 2007 to June 2009, 25 patients with far lateral lumbar disc herniation were treated with unilateral lumbar pedicle screw fixation and intervertebral body fusion. There were 12 males and 13 females,which ranged in age from 37 to 68, with an average of 54.6 years. The course of disease was from 3 to 36 months with an average of 8.8 months. All the patients had pain and/or numbness and/or soreness in front and/or the back of unilateral leg and buttocks; muscle strength, sensation and tendon reflexes had declined of different degrees. Lumbar CT or MRI showed far lateral lumbar disc herniation. Neurological function and lumbar function were respectively evaluated according to JOA 29 score system (including subjective, objective symptom and bladder function) and Oswestry disability index (ODI).

RESULTS

All the patients were followed-up from 12 to 36 months with an average of 24 months. Postoperative wound healed well and no perioperative complications and follow-up complications were found. Neurological function of patients obtain recovery of difference degrees. At final follow-up, JOA score and ODI improved compared with that of preoperative data (P < 0.01); the mean improvement rate of JOA score was 94.3%. All patients got good bone fusion and no recurrence cases were found.

CONCLUSION

Unilateral lumbar pedicle screw fixation and intervertebral body fusion could increase the initial stability after fusion, restore and maintain the intervertebral height, and elevate the improvement rate in treating far lateral lumber disc herniation. The surgical method is safe, effective and reliable, but need to strictly control indications.