| Objectives:To study the effectiveness of treatment of FLLDH by TLIF,and to discuss advantages and limitations of TLIF.Methods: There were 30 patients of FLLDH were treated by the way of surgical method mentioned above in Spinal Surgery in the period of March 2011 to March 2014.To divided those patients into two groups before the operation and each group had 15 cases. TLIF group was given the treatment of unilateral transforaminal lumbar interbody fusion while PLIF group was given the treatment of posterior lumbar interbody fusion.The whole of those operations were completed by the professor Guan Zhong. ALL of those patients would have positive conservative treatment such as Analgesics 、 symptomatic treatment and enough bed rest in the time of pre-operation. After operation they would be treated with anti-inflammation 、dehydration、hemostasis and best support care.Recordthe VAS and JOA score before the operation.According to the projectand statistics the operation time, bleed during operation,operative incision lengths, duration for bed restof two groups. Recored VAS and JOA score when the follow-up of 3 month have been done.Review of the lumbar spine X-ray when 3 months、6 months、1 year after the operation, observation of intervertebral fusion rate and recored the fuse time.Results: Operation time、bleed during operation of unilateral TILF group is be inferior to the TILF group dose.(P<0.05). Operative incision lengths、 duration of hospital stays、intervertebral fusion rate and convergence time of two groups had a little discrepancies. The unilateral TILF group:operation time 116.5±13.2min, bleed during operation247.3±46.8ml, operative incision lengths7.09±0.1cm, duration of hospital stays 4.4±0.83d; intervertebral convergence time3.8±1.12 month, intervertebral fusion rate is 80%. The TILF group: operation time180.0±20.9min, bleed during operation454.6±56.9ml, operative incision lengths7.12±0.2cm, duration of hospital stays4.6±0.81 d, intervertebral convergence time4.0±1.36 month,intervertebral fusion rate is 86.67%. It would have efficiencies of statistics when follow-up in 3 month after operation,the efficiencies of two squad were80.0% and 73.33%.To Comparative uperlative and find it has statistical criteria(P<0.05).The VAS score is7.71±0.62 、2.30±0.84 before and after operation of unilateral TILF group,and the average improvement rate is(70.63±8.6)%. The JOA score is 11.86±2.1 、 20.80±3.5 before and after operation of unilateral TILF group, the average improvement rate is(775.2±8.6)%.To the PLIF group, The VAS score is 8.26±0.56、2.41±0.71 before and after operation, the average improvement rate is(71.31±8.1)%. The JOA score is 11.93±1.8、 20.86±3.5 before and after operation, the average improvement rate is(74.8±9.6)%。Clusion: Unilateral TLIF hassmaller trauma,speedy recovery that contrasted with PLIF,so it would be an sureness and valid method in the cure of lateral and far lateral lumbar disc herniation. |
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