Mini-open ALIF in the treatment of patients with recurrent lumbar disc herniation / 中华骨科杂志

ABSTRACT

Objective To evaluate the effects of mini-open anterior lumbar interbody fusion (ALIF) in the treatment of recurrent lumbar disc herniation (RLDH).Methods From February 2001 to February 2012,20 patients of RLDH who underwent mini-open ALIF were retrospectively analyzed.There were 8 male and 12 female with an average age of 53.1±5.9 years (range,44-68 years).The SynFrame retractor system and SynFix-LR interbody cage were used in operation.The operative time,intraoperative blood loss,blood drainage of 24 hours postoperatively and hospital stay were recorded.In addition,visual analogue scale (VAS)and Oswestry disability index (ODI) of pre-operation,2 days,3,6 and 12 months postoperatively were evaluated.Results All patients were followed up for 12-110 (average,45.6±29.6) months,postoperative VAS score and ODI percent decreased significantly comparing with that of pre-operation (P＜0.05).However,no remarkable difference (P＞0.05) was found among that of 2 days,3,6,12 months postoperatively.Average VAS score was 7.7±0.7 before operation and 1.7±0.9 at 12-month follow-up.Average ODI percent was 80.6％±3.9％ before operation and 6.6％± 1.3％ at 12-month follow-up.Intraoperative blood loss was 90-220 ml (average,126.0±40.3 ml) and postoperative blood drainage at 48 h was 35-63 ml (average,47.5±7.6 ml).Hospital stay was 4-11 days (average,6.7± 1.8 days).All patients had achieved solid fusion after 6 months' follow-up.All these implants were in good places without displacement or hardware failure.Conclusion Mini-open ALIF can result in fewer invasions,significantly relieve symptoms and improve patients' function in the treatment of RLDH.Moreover,it can increase fusion rate with fewer complications,which can obtain a satisfactory short-or mid-term effect.