title: [A feasibility research of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation for recurrent lumbar disc herniation].
abstract: OBJECTIVE
  To investigate the feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation of pedicle screws and a translaminar facet screw for recurrent lumbar disc herniation.
  
  
  METHODS
  From January 2010 to December 2011, 16 recurrent lumbar disc herniation patients, 10 male and 6 female patients with an average age of 45 years (35-68 years) were treated with unilateral incision MIS-TLIF through working channel. After decompression, interbody fusion and fixation using unilateral pedicle screws, a translaminar facet screw was inserted from the same incision through spinous process and laminar to the other side facet joint. The results of perioperative parameters, radiographic images and clinical outcomes were assessed. The repeated measure analysis of variance was applied in the scores of visual analogue scale (VAS) and Oswestry disablity index (ODI).
  
  
  RESULTS
  All patients MIS-TLIF were accomplished under working channel including decompression, interbody fusion and hybrid fixation without any neural complication. The average operative time was (148 ± 75) minutes, the average operative blood loss was (186 ± 226) ml, the average postoperative ambulation time was (32 ± 15) hours, and the average hospitalization time was (6 ± 4) days. The average length of incision was (29 ± 4) mm, and the average length of translaminar facets screw was (52 ± 6) mm. The mean follow-up was 16.5 months with a range of 12-24 months. The postoperative X-ray and CT images showed good position of the hybrid internal fixation, and all facets screws penetrate through facets joint. The significant improvement could be found in back pain VAS, leg pain VAS and ODI scores between preoperative 1 day and postoperative follow-up at all time-points (back pain VAS:F = 52.845, P = 0.000;leg pain VAS:F = 113.480, P = 0.000;ODI:F = 36.665, P = 0.000).
  
  
  CONCLUSIONS
  Recurrent lumbar disc herniation could be treated with MIS-TLIF using hybrid fixation through unilateral incision, and the advantage including less invasion and quickly recovery.
authors.affiliation: Department of Orthopedics, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Ke-ya
authors.initials: KY
authors.lastname: Mao
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Song-hua
authors.initials: SH
authors.lastname: Xiao
authors.forename: Yong-gang
authors.initials: YG
authors.lastname: Zhang
authors.forename: Bao-wei
authors.initials: BW
authors.lastname: Liu
authors.forename: Zheng
authors.initials: Z
authors.lastname: Wang
authors.forename: Xi-Feng
authors.initials: XF
authors.lastname: Zhang
authors.forename: Geng
authors.initials: G
authors.lastname: Cui
authors.forename: Xue-song
authors.initials: XS
authors.lastname: Zhang
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.forename: Ke-zheng
authors.initials: KZ
authors.lastname: Mao
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D005240:Feasibility Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D013123:Spinal Fusion