Quadrant System in lumbar disc herniation treatment of lumbar instability

doi:10.3969/j.issn.2095-4344.2013.30.023

Abstract

Abstract:

BACKGROUND: There are still about 10%-30% of patients presenting no obvious improvement of symptoms after lumbar disc herniation surgery, which are collectively known as the lumbar spine post-surgery failure syndrome, and lumbar instability is one of the important reasons.
OBJECTIVE: To evaluate the feasibility and efficacy of surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation on lumbar intervertebral disc protrusion concurring lumbar instability via MAST Quadrant retractor.
METHODS: From December 2011 to October 2012, 62 cases of lumbar intervertebral disc protrusion concurring lumbar instability were treated with posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor. There were 38 female and 24 male ranging in age from 37 to 69 years (average 53.7 years). After operation, all patients were followed-up to evaluate the effect of the treatment.
RESULTS AND CONCLUSION: The operative time was 90-210 minutes, average 145 minutes, and the amount of blood loss was 50-300 mL, average 120 mL. The hospitalization time was 5-9 days, average 6 days. All incisions healed by first intention. All patients were followed up 7.2 months on average (from 3 to 10 months). The preoperative JOA score was (10.25±2.34) points. The postoperative JOA score decreased to (18.31±3.12) points at the follow-up after 1 month and (25.35±2.61) points at the last follow-up, showing significant difference when compared with preoperative score (P < 0.01). The preoperative VAS score was (8.24±1.15) points. The postoperative VAS score decreased to (2.97±1.12) points after 1 month and (1.13±0.39) points at the last follow-up, showing significant difference when compared with preoperative score (P < 0.01). According to reforming Macnab standard, the results were excellent in 53 cases and good in 9 cases at the last follow-up. The surgery including posterior lumbar spinal canal decompression, intervertebral disc resection, lumbar interbody fusion, and pedicle screw fixation via MAST Quadrant retractor is a safe, effective and minimally invasive surgical technique in treating lumbar intervertebral disc protrusion concurring lumbar instability.

Key words: bone and joint implants, academic discussion of bone and joint, Quadrant System, lumbar intervertebral disc protrusion, lumbar instability, pedicle screw fixation, bone graft fusion, lumbar spinal canal decompression, disc resection

CLC Number:

R318

Wei Jin-song, Zeng Rong, Chen Si-yuan, Wei Bo, Lin Hao. Quadrant System in lumbar disc herniation treatment of lumbar instability [J]. Chinese Journal of Tissue Engineering Research, 2013, 17(30): 5563-5568.

Figures/Tables 6

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