Transforaminal lumbar interbody fusion via Quadrant invasive system for recurrent lumbar disc herniation: an analysis of surgical outcome

English Keywords:Recurrent lumbar disc herniation  Transforaminal lambar interbody fusion  Quadrant system  Effect

English Abstract:

  【Abstract】 Objectives: To investigate the surgical outcome of minimal invasive transforaminal lumbar interbody fusion via bilateral paramedian approach under Quadrant invasive system for recurrent lumbar disc herniation． Methods: From January 2009 to December 2011, the clinical data of 22 patients(average age 51.2 years, ranging 35-65 years old) suffering from recurrent lumbar disc herniation（10 cases under window of laminar, 8 cases under MED, 4 cases under hemilaminectomy） were reviewed retrospectively. A total of 22 segments was involved, including L4/5 in 16 cases, L5/S1 in 6 cases. All 22 cases underwent minimal invasive transforaminal lumbar interbody fusion via bilateral paramedian approach under Quadrant invasive system. JOA(29) score was used to evaluate the pre-and post-revision operation(12 months) outcome as well as the improvement rate. Suk′s method was used to evaluate the lumbar interbody fusion. Results: The operations were completed successfully in all the 22 patients, and no cerebrospinal fluid leakage and nerve root injury were noted. All patients were followed up for 18-37 months(mean, 24 months). The mean JOA score at preoperation and 12 months after operation was 9.8±1.4 and 24.5±1.2 respectively, which showed statistical significance(P<0.05). Based on the improvement rate, there were 20 excellent and 2 good. All cases got bony fusion with the fusion time of 5-12 months(mean, 9.3 months). No instrument failure was noted. Conclusions: Minimal invasive transforaminal lumbar interbody fusion via bilateral paramedian approach under Quadrant invasive system is reliable and effective for the treatment of recurrent lumbar disc herniation．