Disc herniation in the thoracolumbar junction treated by minimally invasive transforaminal interbody fusion surgery.
Minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF) has demonstrated efficacy in the treatment of lumbar degenerative diseases. Use of this procedure for thoracolumbar junction disc herniation remains challenging. Reports concerning MIS-TLIF at the thoracolumbar junction are rare. Thus, we performed a retrospective analysis of the clinical outcomes of 10 patients with thoracolumbar junction disc herniation treated by MIS-TLIF between December 2007 and October 2010. The purpose of this study was to investigate the efficacy and safety of MIS-TLIF for disc herniation in the thoracolumbar junction. Clinical and radiological data were collected and analyzed. Fusion levels included T12-L1 (two patients), L1-L2 (four patients) and L2-L3 (four patients). Clinical outcome was assessed using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). The average follow-up period was 39.2 months, with a minimum of 24 months. The mean ± standard error of the mean of the operative time, intraoperative blood loss, and x-ray exposure were 128 ± 36 minutes, 204 ± 35 mL, and 43 ± 12 seconds, respectively. The VAS for back and leg pain decreased significantly postoperatively from 6.4 ± 2.7 to 1.5 ± 0.6 (p<0.01), and from 7.1 ± 2.4 to 1.3 ± 0.4 (p<0.01) respectively, as did the ODI from 39.3 ± 11.2 to 16.5 ± 4.7 (p<0.01). Bone fusion was observed in eight patients. There were no other major complications at last follow-up. MIS-TIF is a safe and effective procedure for disc herniation in the thoracolumbar junction. Occurrence of non-union is relatively high compared to previous findings.
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, 2 Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China. Electronic address: tonywjxq@yahoo.com.cn.
Jian
J
Wang
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, 2 Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China.
Yue
Y
Zhou
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, 2 Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China.
Zheng Feng
ZF
Zhang
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, 2 Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China.
Chang Qing
CQ
Li
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, 2 Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China.
Wen Jie
WJ
Zheng
Department of Orthopaedic Surgery, Affiliated Xinqiao Hospital, The Third Military Medical University, 2 Xinqiao Street, Shapingba District, Chongqing 400037, People's Republic of China.
Bo
B
Huang
D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome
Disc herniation; Minimally invasive spine surgery; Thoracolumbar junction; Transforaminal lumbar interbody fusion