Laminectomy with transforaminal discectomy and lumbar interbody fusion for upper lumbar disc herniation

English Keywords:Upper lumbar disc herniation  Discectomy  Transforaminal lumbar interbody fusion

English Abstract:

  【Abstract】 Objective：To investigate the efficacy of laminectomy with transforaminal discectomy and lumbar interbody fusion for upper lumbar disc herniation.Method：22 cases with upper lumbar disc herniation undergoing laminectomy，transforamina discectomy and lumbar interbody fusion（18 cases with partial laminectomy，4 cases with total laminectomy） in our hospital from Mar 2005 to Dec 2008 were reviewed retrospectively，the involved level included L1/2 in four cases，L2/3 in nine cases and L3/4 in nine cases.Oswestry score was used to evaluate the neurological status，VAS score and Mochida′s score were used to assess low back pain and the intervertebral space height respectively before operation and 1 year after operation.Schulte method was used to evaluate the fusion status 1 year after operation.Result：The average operation time was 132.6min，the average intraoperative blood loss was 263ml and no spinal dura mater injury was noted.1 patients was complicated with contralateral nerve root stretch injury，which was resolved after conservative treatment.All the patients were followed up for more than one year.The preoperative VAS，ODI and R value were 8．3±0．6，（52．32±9．17）% and 0.211±0.052 respectively；one year after operation the counterparts were 2．1±0．8，（20．33±5．72）%，0.324±0.048 respectively，which showed significant improvement，and bony union rate was noted as 95% except 1 case of uncertain.No implant failure was found.Conclusion：Laminectomy with transforaminal discectomy and lumbar interbody fusion for upper lumbar disc herniation is reliable and effective.