[Treatment of degenerative disc disease by transforaminal lumbar interbody fusion].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008 Aug; 22(8):914-7.ZX
To discuss the key issues in the diagnosis and treatment of degenerative disc disease and the therapeutic effect of transforaminal lumbar interbody fusion on it.
From September 2004 to August 2006, 15 cases of degenerative disc disease were treated by transforaminal lumbar interbody fusion, including 8 males and 7 females with the age of 33-46 years. All cases were single-level degenerative disc diseases, including 1 case of L3,4, 8 cases of L4,5 and 6 cases of L5, S1. The course of the disease was 2 -10 years. Preoperatively, the score of visual analogue scale (VAS) was 8.9 +/- 1.8 and the score of Oswestry disability index (ODI) was 51.4 +/- 8.3. All patients had received normal conventional treatment for at least 3 months and had no therapeutic effect before operation.
The operation time was 120-180 minutes (150 minutes on average) and the intra-operative blood loss was 200-500 mL (360 mL on average). There was no severe complication, except that the muscle tone of anterior tibia in one case decreased to the third level, which recovered to the 5(-) level 3 months after operation. A total of 15 cases were followed up for 12-24 months (18 months on average). All patients got interbody bony fusion 12 months after operation with the fusion rate of 100%. Postoperatively, the score of VAS was 2.8 +/- 1.6 and the score of ODI was 19.1 +/- 3.2, indicating there were significant difference in comparison with postoperative ones (P < 0.05). The improvement rates of postoperative VAS and ODI were 61.8% +/- 7.3% and 64.3% +/- 5.5%, respectively. For the therapeutic effect, 6 cases were regarded as excellent, 8 good, 1 fair, and the choiceness rate was 93.3%. All patients resumed their jobs and normal lives.
Transforaminal lumbar interbody fusion is effective for the treatment of lumbar degenerative disc disease, but the indications for operation must be strictly defined.