Microendoscopic discectomy versus minimally invasive transforaminal lumbar interbody fusion for lumbar disc herniation with Modic changes
PU Xiaobing
ZHOU Qiang
YANG Shuangshi
XIA Hong
Abstract：Objective To compare the clinical outcomes of microendoscopic discectomy (MED) and minimally invasive transforaminal lumbar interbody fusion (TLIF) for lumbar disc herniation (LDH) with Modic changes. Methods Clinical data of 59 LDH patients with Modic changes were retrospectively analyzed, who were treated in the 188th Hospital of PLA from September 2003 to December 2008. According to different surgical procedures, they were divided into 2 groups, MED group (n = 30) and minimally invasive TLIF group (n = 29). Visual analogue scale (VAS) scores and Oswestry disability index (ODI) scores in 2 groups were evaluated and compared with each other. Results All patients were followed up for 0.5-5 years with the average of 3 years and 2 months. Surgical incision were healed in all patients, and no intervertebral space infection and nerve injury were observed. In MED group, recurrence was found in 5 patients which was proved by clinical symptoms and MRI examination, and then was cured by TLIF; while no recurrence was found in minimally invasive TLIF group, and X-ray showed all 29 patients had bony fusion. At preopertion, there was no statistical difference of VAS and ODI scores between 2 groups (P >0.05). At the final follow-up, VAS and ODI scores improved compared with preoperative results (P <0.05); The scores in minially invasive TLIF group were better than those in MED group, there was statistical difference between 2 groups (P <0.05). Conclusion Compared with MED, minimally invasive TLIF had the advantages of lower recurrence rate, satisfactory pain relief and function rehabilitation.
Keywords：Lumbar vertebraeInervertebral disk displacementEndplate degenerationSurgical proceduresminimally invasiveSpinal fusionEndoscopy
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 79-83 )