Treatment of Lumbar Intervertebral Disc Herniation with Modified Transforaminal Lumbar Inter-body Fusion Combined with Unilateral Pedicle Screw Fixation

Abstract：Objective To explore the clinical application and result of modified transforaminal lumbar interbody fusion (TLIF)with unilateral pedicle screw fixation for the treatment of lumbar intervertebral disc herniation. Methods From De-cember 2010 to April 2014,62 patients with lumbar intervertebral disc herniation were treated by modified TLIF. There were 28 patients in unilateral fixation group,19 males and 9 female,aged from 28 to 57 years old. Fusion located in L1 ~ 2 in 1 case,L2 ~ 3 in 1 case,L3 ~ 4 in 2 cases,L4 ~ 5 in 18 cases,L5 S1 in 6 cases. There were 34 patients in bilateral fixation group,including 22 males and 12 females,aged from 32 to 59 years old. Fusion located in L1 ~ 2 in 1 cases,L2 ~ 3 in 2 cases,L3 ~ 4 in 3 cases,L4 ~ 5 in 19 cases,L5 S1 in 9 cases. Operation time,intraoperative blood loss,postoperative drainage were analyzed between two groups. The clinical outcomes of 2 groups were assessed by visual analog scale(VAS)scores,Oswestry and Japanese Orthopedic Asso-ciation(JOA)scores. Post-operative complicaions were monitored. Results All patients were followed-up for 16. 7 months,op-eration time,blood loss and postoperative drainage of unilateral group reduced significantly compared with bilateral fixation group(P ﹤ 0. 05). In addition,statistical significance was found with respect to postoperative scores of VAS scores,ODI and JOA scores compared with preoperative data( P ﹤ 0 . 0 1 ),whereas no statistical significance between the two groups( P ﹥0. 05). Conclusion The modifled TLIF with unilateral pedicle screw fixation for the treatment of lumbar intervertebral disc herniation is an effective method,which has not only some traditional advantages,such as smaller trauma,less bleeding,no de-struction of the contralateral structures,short operation time,but also more satisfactory function recovery.