RESUMO
Objective To compare the clinical effect of minimally invasive surgery transforaminal lumbar interbody fu-sion(MIS-TLIF)and posterior lumbar interbody fusion(PLIF)in the treatment of recurrent lumbar intervertebral disc hernia-tion(LIDH). Methods Twenty-nine patients with recurrent LIDP were selected from May 2014 to May 2016 in Weifang Peo-ple's Hospital and the clinical data were analyzed retrospectively. Thirteen patients were given MIS-TLIF(MIS-TLIF group) and sixteen patients were given PLIF(PLIF)group. The operative incision length,intraoperative bleeding volume,postoperative drainage volume,hospitalization time and complications were compared between the two groups. The lumbar function was evalu-ated with the Japanese Orthopaedic Association(JOA)score standard,and the clinical effect was compared between the two groups according to the modified Macnab standard one year after treatment. Results The operativeincision length,intraopera-tive bleeding volume,postoperative drainage volumeand hospitalization time in MIS-TLIF group were significantly less than tho-sein PLIF group (P < 0. 05). The preoperative JOA score of lumbar function in PLIF group and MIS-TLIF group was 7. 9 ± 1. 9 and 8. 0 ± 1. 6 respectively,it was 24. 0 ± 2. 7 and 24. 2 ± 2. 5 respectively at one year after treatment,there was no significant-difference in the JOA score between the two groups before and one year after operation (P > 0. 05). The JOA score atone year after operation was significantly higher than that before operation in the two groups (P < 0. 05). According to the modified Macnab standard one year after treatment,the fineness rate of the patients in PLIF group was 87. 50％(14 / 16),the fineness rate of the patients in the MIS-TLIF group was 84. 62％(11 / 13). There was no significant difference in the fineness rate be-tweenthe two groups (χ2 = 1. 380,P > 0. 05). The incidence of postoperative complications in the MIS-TLIF group and PLIF group was 7. 7％(1/ 13)and 6. 3％ (1/ 16)respectively,there was no significant difference in the incidence of postoperative complications between the two groups (χ2 = 0. 020,P > 0. 05). There were 8 cases (61. 5％)with gradeⅠfusion and 5 cases (38. 5％)with gradeⅡfusion in MIS-TLIF group,there were 9(56. 3％)with gradeⅠfusion and 7(43. 8％)with gradeⅡfu-sion,there was no significant difference in the constituent ratio with gradeⅠandⅡfusion between the two groups (χ2 = 0. 080, P >0. 05). Conclusion MIS-TLIF in treatment of recurrent LIDH has the advantages of less incision,less intraoperative bleed-ing,less postoperative drainage and shorter hospitalization time;and the clinical effect of MIS-TLIF is similar to that of PLIF.
RESUMO
<p><b>OBJECTIVE</b>To evaluate the biomechanical and clinical effect of the treatment of thoracolumbar fracture with monosegmental pedicle instrumentation in the fracture vertebrae by endplate method.</p><p><b>METHODS</b>Twenty-four porcine thoracolumbal spinal model, divided into four groups randomly, compared the stability of these four groups through pull-out testing. Retrospective study of 49 patients with thoracolumbar fracture who were treated with this technique, to observe the fusion of bone graft, the height of the anterior and posterior range, the angle of kyphosis and the volume of spinal canal, the loss of rectification, low back pain, and the limitation of activity of lumbar.</p><p><b>RESULTS</b>The endplate method group is more stability than the parallel method group, and the pedicle screw in the fracture vertebrae can get enough stability. After operation all 49 cases achieved satisfactory reduction, strong bone fusion, no reduction loss, no refractoriness low back pain, limitation of motion of lumbar et al.</p><p><b>CONCLUSION</b>Monosegmental pedicle instrumentation by endplate method in the fracture vertebrae for thoracolumbar fracture can get enough extraction stability, and get satisfied clinical effect.</p>