Bilateral paramedian approach under quadrant system for lumbar revision surgery

English Keywords:Minimal invasive  Quadrant system  TLIF  Revison  Lumbar

English Abstract:

  【Abstract】 Objective：To investigate the clinical outcome of minimal invasive transforaminal lumbar interbody fusion（TLIF） via bilateral paramedian approach for lumbar revision surgery.Method：From March 2007 to February 2010，the clinical data of 24 patients suffering from failed primary lumbar surgery（8 discectomics due to LDH under MED，10 discectomics due to LDH under window of laminar，6 windows of laminas due to lumbar spinal stenosis） were reviewed retrospectively.A total of 24 segments were involved，including L4/5 in 13cases，L5/S1 in 11 cases.All 24 cases suffering from failed back surgery syndrome underwent minimal invasive TLIF via bilateral paramedian approach under MAST Quadrant system.JOA（29） score system was used to evaluate the pre-and post-revision operative（12 months） outcome as well as the improvement rate.Result：All patients were followed up for 14～26 months（mean，16 months）.No cerebrospinal fluid leakage and nerve root injury were noted.The mean JOA score for preoperation and 12 months after operation was 13.91±1.44 and 23.70±1.33 respectively，which showed statistical significance（P<0.05）.Based on the improvement rate，there were 17 excellent，5 good and 2 fair.Conclusion：Minimal invasive transforaminal lumbar interbody fusion via bilateral paramedian approach under quadrant system is reliable and effective for lumbar revision surgery.