title: Four-year follow-up results of transforaminal lumbar interbody fusion as revision surgery for recurrent lumbar disc herniation after conventional discectomy.
abstract: This study investigated the safety, effectiveness, and clinical and radiological outcomes of transforaminal lumbar interbody fusion (TLIF) for recurrent lumbar disc herniation (rLDH) following previous lumbar spine surgery. Seventy-three consecutive patients treated for rLDH between June 2005 and May 2012 were included in the study. The previous surgical procedures included percutaneous discectomy, discectomy with laminotomy, discectomy with unilateral laminectomy, and discectomy with bilateral laminectomy. The level of rLDH was L4-L5 in 51 patients, L5-S1 in 19 patients, and L3-L4 in three patients. All patients underwent reoperation using the TLIF technique. Outcomes were evaluated using the Oswestry disability index (ODI), visual analogue scale (VAS) scores for low back pain and leg pain, and the Japanese Orthopaedic Association (JOA) score, based on the results of physical examinations and questionnaires. The range of motion and disc height index of the operative segment were compared between preoperative and postoperative radiographs. The mean follow-up period was 4.1 years. The VAS scores for low back pain and leg pain, ODI, and JOA score improved significantly between the preoperative and final follow-up evaluations. The mean recovery rate of the JOA score was 89.0%. The disc space height and stability at the fused level were significantly improved after surgery. The fusion rate at the final follow-up was 93.2%. There were no major complications. These results indicate that TLIF can be considered an effective, reliable, and safe alternative procedure for the treatment of rLDH.
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, No. 51, Fucheng Road, Beijing, People's Republic of China.
authors.forename: Zhonghai
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, No. 51, Fucheng Road, Beijing, People's Republic of China.
authors.forename: Jiaguang
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, No. 51, Fucheng Road, Beijing, People's Republic of China. Electronic address: lvshunman@vip.126.com.
authors.forename: Shuxun
authors.initials: S
authors.lastname: Hou
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, No. 51, Fucheng Road, Beijing, People's Republic of China.
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Ren
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, No. 51, Fucheng Road, Beijing, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, No. 51, Fucheng Road, Beijing, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA Second Military Medical University, Shanghai, People's Republic of China.
authors.forename: Tiesheng
authors.initials: T
authors.lastname: Hou
mesh_terms: D000328:Adult; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D020127:Recovery of Function; D012008:Recurrence; D012086:Reoperation / Q000379:methods*; D013123:Spinal Fusion / Q000379:methods*
keywords: Discectomy; Fusion; Lumbar spine; Recurrent lumbar disc herniation; Transforaminal lumbar interbody fusion