Comparative study of posterior or anterior lumbar interbody fusion operation for superior position intervertebral disc herniation / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate the curative effects of the posterior or anterior lumbar interbody fusion for the treatment of superior position intervertebral disc herniation. [Method] Forty-seven patients with superior position intervertebral disc herniation were followed up.There were 29 males and 18 females with mean age of 53.3 years(from 35 to 67 years).Twewty-five patients were treated with posterior lumbar interbody fusion(PLIF)using facet joint autograft and cage additional of pedicle screw internal fixation(posterior way group),and 22 patients were treated with anterior disckectomy,bone graft and plates internal fixation(anterior way group).The mean follow-up time was 53.5?5 months(from 24 to 78 months).The clinical results were compared between two groups.Clinical functional assessment standard was used to evaluate the clinical curative effect.The changes of the therapeutic effects,the radiographic findings and complications were evaluated.[Result]In regard to the operation time and bleeding,the posterior way group was superior to anterior way group.There was no difference between the two groups in clinical recovery rates and nerve root injury rates.Complications included dural tear(n=3),and pedicle screw deviating(n=1) in the posterior way group;and dural tear(n=2),unilateral transient lower extremity paresthesia(n=3),and hard controlled singultation(n=1) in the anterior way group.The rates of bone fusion were 96.00% and 95.45% in the posterior and anterior way groups. [Conclusion] Operation for the superior position intervertebral disc herniation is effective.The posterior lumbar interbody fusion using facet joint autograft and cage additional of pedicle screw internal fixation to shorten the operation time and decrease bleeding is recommend for the treatment of superior position intervertebral disc herniation.