title: Bilateral transformational thoracolumbar interbody fusion for the treatment of giant central thoracolumbar junction disc herniation: A prospective clinical and radiological study.
abstract: METHODS
  Clinical and radiological assessment of prospective single-center data.
  
  
  BACKGROUND
  The optimal treatment strategy for giant central thoracolumbar junction disc herniation (TLDH) remains controversial.
  
  
  OBJECTIVE
  This study aimed to report the clinical and radiological results of bilateral transformational thoracolumbar interbody fusion (bilateral TTIF) to treat giant central TLDH.
  
  
  METHODS
  Seventeen consecutive patients with giant central TLDH underwent bilateral TTIF from January 2014 to June 2014 and were followed for 9-15 months. Clinical and radiological data were prospectively examined, including operative time, blood loss, pre- and postoperative American Spinal Injury Association (ASIA) score for sensory and motor function, visual analog scale (VAS) and Oswestry Disability Index (ODI) scores, fusion rate, extent of decompression, rate of instrumentation failure, and complications.
  
  
  RESULTS
  The average time of surgery was 160 ± 37 min, and blood loss was 884 ± 197 ml. The ASIA sensory and motor scores improved from 72.76 ± 3.36 to 90.71 ± 2.54 and from 68.47 ± 4.7 to 88.0 ± 3.2, respectively. VAS for back pain and ODI decreased from 6.65 ± 1.93 to 2.23 ± 0.56 and from 42.82 ± 5.08 to 11.3 ± 2.3, respectively. Canal encroachment improved from 50.3 ± 6.6% to 2 ± 0.3% at the last follow-up. Surgery complications were seen in 5 patients (29%), who experienced intraoperative dural tear and cerebrospinal fluid leak. There were no other major complications at the last follow-up.
  
  
  CONCLUSIONS
  Bilateral TTIF produced satisfactory outcomes and may be one of the surgical treatments of choice for myelopathy due to giant central TLDH.
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China; Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University health science center, Nanguo Road No.76, Xi'an 710054, Shan'xi Province, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Wentao
authors.affiliation: Department of General Surgery, The 417th Hospital, China National Nuclear Corporation (CNNC), Xi'an 710064, Shan'xi Province, China.
authors.forename: Duan
authors.initials: D
authors.lastname: Kun
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Tuanjiang
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China; Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University health science center, Nanguo Road No.76, Xi'an 710054, Shan'xi Province, China.
authors.forename: Ma
authors.initials: M
authors.lastname: Minjie
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China; Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University health science center, Nanguo Road No.76, Xi'an 710054, Shan'xi Province, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Yong
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China.
authors.forename: He
authors.initials: H
authors.lastname: Baorong
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China.
authors.forename: Wu
authors.initials: W
authors.lastname: Qining
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Jijun
authors.affiliation: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, Shan'xi Province, China; Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University health science center, Nanguo Road No.76, Xi'an 710054, Shan'xi Province, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Dingjun
keywords: Bilateral transformational thoracolumbar interbody fusion; Giant central thoracolumbar junction disc herniation; Prospective clinical and radiological study