The Anatomical Study And Clinical Application On Transforminal Lumbar Interbody Fusion

Objective: To investigate some correlated data with transforaminal lumbar interbody fusion(TLIF)inorder to standardize and improve surgical procedure theoretically. Methods: Anatomical study: Fourteen normal adult body preservation of the lumbar spine were observed on intervertebral foramen width, length, height; the distance from structure of the lumbar spine to the midst sagittal plane from L₁ to L₅ were measured as well. Clinical application: 17 patients who underwent TLIF with single posterolateral threaded cage insertion transpedicular screw rod fixation are reported, and the clinical outcome are evaluated. Results: Anatomical study shows that lumbar intervertebral foramen width gradually become smaller from L₁ to L₅; The lumbar intervertebral foramen height is gradually increasing from L₁ to L₄, L₅ slightly smaller than L₄, its height highly were significantly greater than the width from L₁ to L₅; The length of intervertebral foramen is gradually increasing from L₁ to L₅ as well. The distance from the lateral margin of the pars interarticularis to the midst sagittal plane from L₃ to L₅ is gradually increasing, the distance from inferior articular process to themidst sagittal plane from L3 to L5 is as well, there was no significant difference from two groups to about the difference(.P>0.05). All patients were followed up from 8 to 24 months(average 11.5M), results show that patients with symptoms ease the rate of 94.12 percent, after one year fusion rate was 100 percent and satisfaction rate of 90 percent subjective. The mean JOA score was improved from (11.5±1.8) before surgery to (22.4±1.8) at 1 month postoperation and (24.3±2.4) at the final follow-up visit. the average disc height was improved from (6.4±1.7) before surgery to (11.3±1.8) at 1 month post-operation and (11.2±1.1) at the final follow-up visit. JOA score of follow-up investigations increased significantly than that of preoperation (P<0.05), the average disc height post-operation decreased significantly than that of preoperation (P< 0.05) , but it has lost minimally when compared the height of disk post-operation with the final follow-up visit after surgery (P>0.05) . there was no fusion of displacement of all patients. Conclusions: Single posterolateral threaded fusion cages can be inserted by intervertebral foramen approach, Transforaminal lumbar interbody fusion using single anatomical threaed cage insertion and transpedicular screw rod fixation can provide good stability with minimal damage, simple. There is a integration and the high rate of theadvantages of good results.