Degenerative changes in adjacent segments after lumbar fixation and fusion：transforaminal endoscopic spine system / 中国组织工程研究

ABSTRACT

BACKGROUND:Spine minimaly invasive technique through foraminal mirror is the method to treat lumbar disc herniation with minimal wound. This technique can be conducted under local anesthesia, and does not need to resect the smal joint or destroy the vertebral plate, and has smal damage to the spine. OBJECTIVE: To explore the short-period effects of transforaminal endoscopic spine system for adjacent-segment degenerative changes-caused low back pain after lumbar fixation and fusion. METHODS:A total of 31 patients with degenerative changes after posterior lumbar bone graft fusion fixation, who required secondary surgery, were enroled in this study, including 23 males and 8 females, at the age of 45-81 years old. The postoperative time was 1.1-5.7 years. There were 3 cases of L3-4 single segment, 15 cases of L4-5 single segment, 8 cases of L5S1 single segment, and 5 cases of multi-segment. These patients were treated with transforaminal endoscopic spine system, and folowed up for 6 months. Visual Analogue Scale score and lumbar function Japanese Orthopedic Association score were observed. RESULTS AND CONCLUSION: Lumbar and leg pain symptoms were relieved noticeably during the operation. The patient could walk immediately after the surgery, and the postoperative recovery was quite satisfactory. Visual Analogue Scale score was lower immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Lumbar function Japanese Orthopedic Association score was higher immediately, 1, 3 and 6 months after treatment compared with pre-treatment. Results verify that transforaminal endoscopic spine system for degenerative changes after posterior lumbar bone graft fusion fixation has some advantages such as high safety, short operation time, less hemorrhage, less complications, rapid restoration and easily accepted by patients.