Single-cage interbody fusion combined with single-side pedicle screw fixation for single-side lumbar disc herniation

Chen Ji-feng; Sheng Wei-bin; Huang Bo; He Bo; Xu Tao

doi:10.3969/j.issn.2095-4344.2013.43.009

Abstract：BACKGROUND:As for patients with one-side backleg pain who were candidates for surgery treatment of lumbar intervertebral disc herniation, the common treatment includes lumbar vertebral plate opening and decompression, and laminectomy in combination with compression and bilateral pedicle screw fixation. However, these therapeutic approaches are not satisfactory. OBJECTIVE:To explore the feasibility and efficiency of single-side lumbar interbody fusion and unilateral pedicle screw fixation for treatment of lumbar intervertebral disc herniation patients with one-side backleg pain. METHODS:Forty patients with single-side lumbar disc herniation, suffering from unilateral backleg pain, were recruited from Shihezi People’s Hospital, China and were treated with single-side lumbar interbody fusion and unilateral pedicle screw internal fixation. The neurological function of patients was assayed using Japanese Orthopaedic Association score system before and after treatment, the improvement rate and excellent/good rate were calculated. Suk criterion was used to determine fusion status. RESULTS AND CONCLUSION:The mean fol ow-up period for 40 patients was ranging from 6 months to 60 months. Al incisions healed wel , with no infection. The Japanese Orthopaedic Association score after 6 months of treatment was significantly higher than that before treatment (P<0.05), with the excellent and good rate up to 88%. According to Suk criterion, 38 patients achieved bone graft fusion or possible fusion, with interbody fusion rate 95%, as revealed by radiographic and CT evidence. The remaining two patients were detected fusion at 9 months after treatment. Our findings indicate that, single-cage lumbar interbody fusion combined with single-side pedicle screw fixation is the feasible surgical technique and provides satisfactory effects in treating single-side lumbar disc herniation.