title: [Treatment of lumbar disc herniation by modified transforaminal lumbar interbody fusion with a pedicle screw system].
abstract: OBJECTIVE
  To evaluate the outcomes of modified transforaminal lumbar interbody fusion in patients with lumbar disc herniation.
  
  
  METHODS
  Forty-six cases of lumbar disc herniation were treated by modified transforaminal lumbar interbody fusion. There were 32 males and 14 females with a mean age of 47 years old (range: 27 - 65). The mean course of disease was 7.5 years (range: 4 - 18). Eighteen cases were of single-level lumbar disc herniation, including L3/4 (n = 5), L4/5 (n = 8) and L5/S1 (n = 5). There were 28 cases with lumbar degenerative diseases at other levels. Preoperatively, the score of visual analogue scale (VAS) was 8.9 ± 1.3 and the score of Oswestry disability index (ODI) was 57.3 ± 5.2. All patients received a normal conservative treatment for at least 3 months with no therapeutic effect at pre-operation.
  
  
  RESULTS
  Forty-six cases had an average follow-up of 20 months (range: 12 - 20). The operative duration was an average of 160 minutes (range: 120 - 180). And the average volume of intra-operative blood loss was 550 ml (range: 400 - 800). There was no severe complication. The symptoms became stable after three months. At 3 months postoperatively, the score of VAS was 2.0 ± 0.4 and the score of ODI 15.2 ± 3.4. And there were significant differences between preoperative and postoperative values (P < 0.05). The improvement rates of postoperative VAS and ODI were (80.1 ± 4.7)% and (73.6 ± 2.8)% respectively. All patients achieved lumbar interbody bone fusion at 12 months post-operation with a fusion rate of 100%. For the therapeutic effect, 34 cases were regarded as excellent, 8 good and 4 fair with an excellent/good rate of 91.3%. All patients began to walk with orthosis after 3 days and resumed their jobs and normal lives after 3 months.
  
  
  CONCLUSIONS
  Modified transforaminal lumbar interbody fusion is effective for the treatment of lumbar disc herniation. Making a detailed operative plan on the basis of preoperative images and symptoms is essential.
authors.affiliation: Department of Orthopedics, Second Hospital of Peking Armed Police, Beijing 100037, China. fangliming92@vip.sohu.com
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Fang
authors.forename: Ya-Jun
authors.initials: YJ
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Nan
authors.initials: N
authors.lastname: Huang
authors.forename: Hua-Gang
authors.initials: HG
authors.lastname: Lin
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.forename: Ji-Yuan
authors.initials: JY
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome