[Fenestration with the spinous process resection in the treatment of central protrusion of lumbar intervertebral disc].
OBJECTIVE
To explore a operative approach and its effect to the central protrusion of lumbar intervertebral disc.


METHODS
From February 1999 to December 2005,34 patients with central protrusion of lumbar intervertebral disc were treated with an improved operative procedure. The study involved 25 males and 9 females with an average of 46.4 years (range, 35 to 63 years). The involved level of herniation were at L4,5 in 20 cases and L5S1 in 14 cases. Pains happened on one leg fixedly and seriously with another lightly in 21 cases, on one leg initially and lightly with another seriously later in 8 cases, on bilateral legs alike in 5 cases. Preoperative CT film showed central type in 8 cases and laterocentral type in 26 cases. The corresponding spinous process was resected on the basis of unilateral fenestration. The supraspinous ligament was retained and pulled to the opposite side for revealing spinal canal, and then diskectomy was done. The above procedure was named "fenestration with the spinous process resection".


RESULTS
All the 34 patients were followed up for 1 to 5 years. The outcome was evaluated according to the standard of HOU Shu-xun, 20 cases were excellent, 11 good and 3 fair. The total rate of excellent and good was 91.2%.


CONCLUSIONS
The "fenestration with the spinous process resection" not only completed decompression of spinal canal and diskectomy, but also retained opposite lamina and supraspinous ligament and maintained the stability of posterior vertebral column, which are a new improved approach for the central protrusion of lumbar intervertebral disc.
Tang
Xiao-Zheng
XZ
Department of Orthopaedics, Jiangxi Provincial People's Hospital, Nanchang 330006, Jiangxi, China. tangxiaozheng@medmail.com.cn
Liu
Ya-Yun
YY
Hu
Jian-Min
JM
Xiao
Yu-Hua
YH
He
Pei-Sheng
PS
Gong
Fei-Peng
FP
Li
Kai-Lu
KL
D000328:Adult; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged