Treatment of minimally invasive lateral interbody fusion for lumbar disc herniation with intervertebral space collapse

WU Zenghui; XU Junjie; WANG Jianhua; WANG Xinyu; ZHANG Kai; XIA Hong

doi:10.3969/j.issn.1674-666X.2014.05.002

Abstract：Objective To explore the feasibility and clinical efficacy of minimally invasive lateral interbody fusion (mini-LIF) for the treatment of lumar disc herniation (LDH) with intervertebral space collapse. Methods Clinical data of 15 patients of LDH with intervertebral space collapse treated in Guangzhou General Hospital of Guangzhou Military Command from April 2008 to August 2013 were retrospectively analyzed, in which there were 10 male and 5 female, with the average age of 52 years old (34-78 years old). The operative segments involved L1/2 in 2 patients, L2/3 in 4, L3/4 in 6 and L4/5 in 3 patients. All of patients underwent pedicle screw fixation anteriorlaterally under the working channel of XLIF/DLIF system. Results All patients underwent the opeations smoothly. The average operative time was 60 min (40-100 min), the estimate blood loss was 20 mL (10-40) mL, incision length was 35 mm (30-40 mm), weight-bearing time was 24 h (12-48 h), and the hospital stay was 5 d (3-7 d). Surgical incisions were healed within normal period of time in all patients. There remained mild pain, numbness, discomfort of inguinal area and inner thigh at surgical side in 5 patients, which vanished after symptomatic treatment. No other operation-related complications occured. All patients were followed up for 12-64 months, with the average time of 35 months. Compared with preoperative ones, visual analogue scale and Oswestry disability index scores at 3 days and 3, 6 and 12 months after the surgery were improved significantly (P <0.05); X-ray and CT examination at six months follow-up showed internal fixators at good position, and all patients got solid fusion. Conclusion For LDH patients with intervertebral space collapse, mini-LIF is feasible and effective method, with the advantages of short operative time, less injury and estimate blood loss, as well as rapid rehabilitation.