[Operative treatment of upper lumbar disc herniation with modified transforaminal lumbar interbody fusion].
OBJECTIVE
To investigate the surgical methods and clinical results of modified transforaminal lumbar interbody fusion and internal fixation for the treatment of upper lumbar disc herniation.


METHODS
Clinical data of 32 cases of upper lumbar disc herniation in our department from June 2005 to June 2009 were retrospectively analyzed. There were 21 males and 11 females, the age from 24 to 59 years with an average of 38.5 years. All the cases were treated by the use of nucleus pulposus removed, modified transforaminal lumbar interbody fusion (TLIF) and internal fixation with pedicle screw system. All patients were followed up with an average of 9 months (from 3 to 18 months), according to Japanese Orthopedic Association (JOA) scores and visual analogue scores (VAS) to evaluate clinical effects.


RESULTS
All the cases were followed up from 3 to 18 months with an average of 9 months and the fusion rate was 100%. The JOA sores before and after operation were 10.5 +/- 2.1, 26.2 +/- 2.4 respectively, and the improvement rate was 84.9%. The VAS before and after operation was 7.2 +/- 1.3 and 1.4 +/- 1.1 respectively, and the rate of catabatic pain was 80.6%. Lumbar rigidity and unwell had 4 cases, obviously leg pain had 2 cases after operation, but the systems vanished gradually at 1-8 weeks after non-operative treatment.


CONCLUSIONS
Modified transforaminal lumbar interbody fusion has the advantages of simple, safe operation and thoroughly decompression, and it is a therapeutic method for upper lumbar disc herniation.
Wei
Zhen
Z
Department of Orthopaedics, Centre Hospital of Zaozhuang Mining Industry Corp., Zaozhuang 277011, Shandong, China.
Xia
Qing
Q
Jiang
Hai-Liang
HL
Li
Li-Xin
LX
Shao
Xue-Ping
XP
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007405:Intervertebral Disc Displacement / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome