Clinical Study On The Treatment Of Lumbar Intervertebral Disc Herniation By Unilateral Internal Fixation Via Posterior Approach

Objective:To investigate the clinical efficacy of Mast quadrant expandable channel system with unilateral pedicle screw fixation combined with interbody fusion with Cage in the treatment of lumbar disc herniation.Methods:From January 2014 to January 2016 in our hospital,147 lumbar disc herniation cases who underwent lumbar intervertebral disc resection,lumbar interbody fusion Cage implantation and pedicle screw internal fixation were analyzed retrospectively,including 59 cases who applied Mast quadrant system of channel expandable treatment and underwent unilateral internal fixation were followed up for an average of 20.39 + 4.45 months;88 cases who underwent traditional open TLIF bilateral internal fixation were followed up for an average of 19.85 + 4.64 months.Comparative analysis of two groups of patients with general information,postoperative hospital stay,operative time,blood loss,hospitalization expenses,post-operative pain visual analogue scale(VAS)and the Japanese Orthopaedic(JOA)score,fusion rate,postoperative 48 hours increase in creatine kinase(CK)and the occurrence complications.Results:(1)compared with bilateral fixation group,the operation time unilateral internal fixation applied channel for the treatment of patients was significantly shortened(P<0.05),intraoperative blood loss was significantly reduced(P<0.05),single group after 48 h creatine kinase(CK)elevated values than bilateral lower group(P<0.05).(2)There was no significant difference between the two groups in postoperative hospitalization time and hospitalization cost(P>0.05).The difference of VAS,ODI,JOA score and bone graft fusion rate was not statistically significant(P>0.05).Conclusion:Mast quadrant expandable channel of unilateral fixation and interbody fusion in the treatment of lumbar disc herniation with bilateral internal fixation of traditional open TLIF had the same effect,but the expandable channel unilateral internal fixation had advantagesof a small surgical trauma,short operation time,less amount of bleeding,but the operation indications should be strictly controlled.