Yu Wu-Liang, Lu Jian-Meng, Wei Yong-Li, Fang Ming, Wang Xing-Wu, Ouyang Jia
Department of Spinal Surgery, the Affiliated Hospital of Medical College of Ningbo University, Ningbo 315020, Zhejiang, China.
Zhongguo Gu Shang. 2013 Jan;26(1):29-32.
To explore the feasibility and clinical efficacy of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion (TLIF) for the treatment of far lateral lumbar disc herniation.
From January 2007 to January 2011, 18 patients with far lateral lumbar disc herniation underwent a unilateral TLIF procedure in conjunction with posterior unilateral pedicle screw fixation. There were 13 males and 5 females,ranging in age from 42 to 73 years (means 58.5 years). All cases had single segment involved 5 cases in L3, 4, 10 cases in L4,5,3 cases in LSS. The visual analog scale (VAS) of low back pain and leg pain and Oswestry Disability Index scores were observed in postoperative and followed-up period, and compared with preoperative.
The operation of 18 patients was successful,there were no severe complication. The average operative time was 105 min (85 to 125 min), the average amount of blood loss was 145 ml (90 to 340 ml). During the followed-up, the visual analog scale and Oswestry disability index scores were significant improved compared with preoperative (P < 0.05). All patients were followed up from 12 to 48 months with an average of 23 months, there was no implant break and displacement in postoperative X-ray.
The surgical procedure of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion had the advantage including less invasion, quickly recovery, short operative time, and saving fixation cost, it may provide an alternative treatment for patients with far lateral lumbar disc herniation.
探讨单侧椎弓根螺钉固定结合经椎间孔腰椎椎体间融合术(TLIF)治疗极外侧腰椎间盘突出症的可行性及临床疗效。
2007年1月至2011年1月,18例极外侧腰椎间盘突出症患者接受了单侧TLIF手术并结合后路单侧椎弓根螺钉固定。其中男性13例,女性5例,年龄42至73岁(平均58.5岁)。所有病例均为单节段受累,L3、4节段5例,L4、5节段10例,L5、S1节段3例。观察术后及随访期间的下腰痛和腿痛视觉模拟量表(VAS)评分及Oswestry功能障碍指数评分,并与术前进行比较。
18例患者手术均成功,无严重并发症。平均手术时间为105分钟(85至125分钟),平均失血量为145毫升(90至340毫升)。随访期间,视觉模拟量表和Oswestry功能障碍指数评分与术前相比显著改善(P<0.05)。所有患者随访12至48个月,平均23个月,术后X线片未见内固定物断裂及移位。
单侧椎弓根螺钉固定结合经椎间孔腰椎椎体间融合术具有创伤小、恢复快、手术时间短、节省固定费用等优点,可为极外侧腰椎间盘突出症患者提供一种替代治疗方法。