Short-term Effect of Minimally Invasive Unilateral Decompression and Fusion with Single Cage in the Treatment of Degenerative Lumbar Disc Herniation

ZHOU Wen-zhong; CHEN Lian; ZHAO Jie

Abstract：Objective:To observe the short-term effect of minimally invasive laminectomy and fusion with unilateral pedicle screw and single Cage implantation in the treatment of degenerative lumbar disc herniation.Method:32 cases of degenerative lumbar disc herniation treated with minimally invasive unilateral decompression and fusion with single Cage in our department from October 2008 to June 2012 were involved in this research.The cases included 13 males and 19 females,aged from 52 to 75 years old,with an average of 61.8 years.Protruding sections:L4-5 15 cases, L5-S1 9 cases,L4-5 and L3-4 3 cases, L4-5 and L5-S1 5 cases,among these cases,17 cases associated with spondylolisthesis instability,11 cases associated with nerve root canal stenosis.Nakai evaluation criteria was adopted to evaluate the curative effect of minimally invasive unilateral decompression and interbody fusion with single cage,X-ray and CT images were used to observe whether postoperative intervertebral displacement happen,and the location of pedicle screws and interbody.Result:The operative time was 75-140 minutes,an average of 95 minutes.Blood loss was 180-550 ml,an average of 380 ml.Concurrent dural tear happened in 3 cases,and nerve root traction injury in 2 cases.Follow-up time was 18 months to 3 years and 8 months,lumbar sequence returned to normal after an average of 25 months.Fusion was assessed by Nakai standard 18 months postoperatively,excellent in 23 cases,good in 7 cases,ameliorateve in 2 cases,and the good rate was 93.8%.Interbody fusion rate assessed by Suk standard was 100% at final follow-up time,no asymptomatic recurrence nor loose or shifting of pedicle screws and interbody happened.Conclusion:The short-term effect of minimally invasive unilateral decompression and fusion with single cage in the treatment of degenerative lumbar disc herniation is good,which is well in maintaining responsibility intervertebral height and segmental stability.