Abstract:

BACKGROUND: The traditional posterior lumbar interbody fusion has many shortcomings and the modified transforaminal lumbar interbody fusion provides a new repairing scheme for surgical treatment of lumbar degenerative diseases.
OBJECTIVE: To observe the clinical efficacy in lumbar degenerative diseases by the modified transforaminal lumbar interbody fusion surgery in the internal fixation system.
METHODS: A retrospective analysis from March 2010 to August 2013 was performed in 30 patients with lumbar degenerative disease, who were treated in the Second People’s Hospital of Changshu, including 6 patients suffering degenerative lumbar spinal stenosis with the Meyerding type I-II, 10 patients suffering lumbar spondylolisthesis, and 14 patients suffering lumbar disc herniation with segmental instability. All the involved patients were treated with internal fixation using the modified transforaminal lumbar interbody fusion surgery. The visual analogue scale scores and Japanese Orthopaedic Association score were recorded before fusion and at last follow-up, and the intervertebral fusion was also observed.
RESULTS AND CONCLUSION: All 30 patients were successfully operated and received a follow-up of more than 12 months, there were no fracture and loosening of fixation. All interbody fusion was very well without Cage sinking or shifting at the last follow-up. The back pain symptoms were significantly improved after fusion. The visual analogue scale score was 6.4±0.8 point before fusion and 1.1±0.6 point at last follow-up, with significant differences (P < 0.001). The Japanese Orthopaedic Association score at the last follow-up (26.5±1.2 point) was significantly improved compared with preoperative scores (12.9±1.6 point), the improvement rate was 83.9±7.9%. There were 27 excellent cases and 3 good cases, the excellent and good rate was up to 100%. Experimental findings indicate that, the modified transforaminal lumbar interbody fusion in the internal fixation system expands surgical indications, develops design ideas and concept of minimally invasive operation of conventional transforaminal lumbar interbody fusion, with simple operation and few complications, it can be selectively applied for the repair of lumbar degenerative disease.

Key words: lumbar vertebra, spinal fusion, internal fixators, pain measurement, follow-up studies