Bilateral Transformational Thoracolumbar Interbody Fusion for the Treatment of Giant Central Thoracolumbar Junction Disc Herniation

Abstract：Objective To explore the efficacy and safety of bilateral transforaminal thoracolumbar interbody fusion (bilateral TTIF) to treat giant central TLDH.Methods Twenty consecutive patients with giant central TLDH underwent bilateral TTIF from January 2014 to June 2015 and were followed for 12 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 analogue 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 (155±27)min,and blood loss was (824±162)mL.The ASIA sensory and motor scores im proved from (72.88±3.26) to (90.34 ± 2.74) and from (67.52± 4.2) to (88.3 ± 3.1),respectively.VAS for back pain and ODI decreased from (6.78±1.99) to (2.34±0.46) and from (44.82±5.18)％ to (11.7±2.4)％,respectively.Canal encroachment improved from (51.3±5.6) ％ to (2±0.5) ％ at the last follow up.Surgery complications were seen in 5 patients (25 ％),who experienced intraoperative dural tear and cerebrospinal fluid leak.There were no other major com plications at last follow-up.Conclusion Bilateral TT1F produced satisfactory outcomes and may be one of the surgical treatments of choice for myelopathy due to giant central TLDH.