Axial lumbar interbody fusion(AxiaLIF) plus posterior microendoscopic lumbar discectomy for lumbosacral degenerative diseases

English Keywords:Axial lumbar interbody fusion  Microendoscopic  Lumbar discectomy  Lumbosacral degenerative diseases

English Abstract:

  【Abstract】 Objectives: To evaluate the clinical outcomes of axial lumbar interbody fusion(AxiaLIF) plus posterior microendoscopic lumbar discectomy for lumbosacral degenerative diseases. Methods: From March 2010 to March 2012, 23 cases suffering from lumbosacral degenerative diseases and undergoing axial lumbar interbody fusion and microendoscopic lumbar discectomy were reviewed retrospectively. There were 13 males and 10 females with the age at time of surgery ranging from 39 to 59 years(mean, 45 years). There were 17 with L5/S1 segment involved, 6 with L4/5 and L5/S1 segment involved. The operation time, blood loss and complications were recorded． Fusion rate was observed． Visual analogue scale(VAS) and Japanese Orthopaedic Association(JOA) scores were used for clinical assessment． Results: The average operation time was 130min(range, 90-170min) and the average intraoperative blood loss was 80ml(range, 50-160ml) in 23 patients． All case were followed up from 6 to 24 months(average, 16.5 months). During follow-up, one patient developed presacral hematoma at the day after operation, while after local dressing and drainage for one week, the hematoma was absorbed. The fusion rate of bone graft body was 82.6% at 6 months of follow-up, 4 cases of postoperative bone fusion time delay, incomplete bony fusion was shown after 12 months of follow-up. There were no other complications occurred else. The VAS score of low back pain for preoperative and final follow-up was 7.19±1.04 and 0.69±0.58 respectively. The VAS score of leg pain for preoperative and final follow-up was 7.27±1.96 and 0.87±0.49 respectively. The JOA score for preoperative and final follow-up was 13.01±2.03 and 26.62±1.25 respectively. Conclusions: Axial lumbar interbody fusion and microendoscopic lumbar discectomy is an effective method for degenerative lumbosacral diseases due to its minimal invasive to the posterior stucture, less intraoperative blood loss and low incidence of complications．