• Department of Orthopaedics, Affiliated Xinqiao Hospital, the Third Military Medical University, Chongqing, 400037, P. R. China;
WANGJian, Email: tonywjxq@aliyun.com
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Objective To investigate the effectiveness and safety of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for upper lumbar disc herniation. Methods Retrospective analysis was made on the clinical data of 26 patients with upper lumbar disc herniation, who were in line with the selection criteria and underwent MIS-TLIF in 14 patients (MIS-TLIF group) and open transforaminal lumbar interbody fusion (OTLIF) in 12 patients (OTLIF group) between December 2007 and May 2012. There was no significant difference in gender, age, disease duration, level of disc herniation, side of disc herniation between 2 groups (P>0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and complications were compared between 2 groups. The clinical outcome was assessed using the visual analogue scale (VAS) and the Oswestry disability index (ODI) scores. The fusion rate was determined by using CT three-dimensional reconstruction and dynamic lumbar radiography at last follow-up. Results Primary healing of incisions was obtained in both groups. No difference was found in operation time between 2 groups (t=0.858, P=0.399), but MIS-TLIF group had less intraoperative blood loss and postoperative drainage volume than OTLIF group (P<0.05). The average follow-up duration was 34.1 months with a range of 12-50 months. No complication of dural tear, infection, spinal nerve trauma, and implant failure occurred. The VAS scores of lower back pain and radicular pain and ODI scores at preoperation showed no significant difference between 2 groups (P>0.05). The VAS score of lower back pain and ODI score at 1 day after operation in MIS-TLIF group were significantly lower than those in the OTLIF group (P<0.05), but no difference was found in VAS scores of radicular pain between 2 groups (P>0.05). Difference in all scores was not significant at last follow-up between 2 groups (P>0.05). The fusion rate was 92.8% (13/14) in MIS-TLIF group, and was 100% (12/12) in OTLIF group at last follow-up. Conclusion MIS-TLIF is a safe and effective procedure for upper lumbar disc herniation as an alternative to other techniques.

Citation: ZHENGYong, WANGJian, YUANChao, ZHENGWenjie, LIChangqing, ZHANGZhengfeng, ZHOUYue. TREATMENT OF UPPER LUMBAR DISC HERNIATION BY MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(4): 480-484. doi: 10.7507/1002-1892.20140108 Copy

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