经椎间孔椎间融合术治疗腰椎间盘再突出

目的探讨经椎间孔椎间融合术（transforam final lumbar interbody fusion，TLIF）治疗腰椎间盘再突出的临床疗效。方法2002年4月-2006年8月，采用TLIF治疗腰椎间盘再突出患者36例，男25例，女11例；年龄为37～68岁，平均51．2岁。手术节段包括L3／L4 2例，L4／L5 19例，L3／S1 15例。采用日本骨科学会JOA评分系统对患者术前、术后神经功能进行评价。结果随访2年，神经功能JOA评分从术前平均9．5分提高至术后平均24．6分（P〈0．01），神经功能改善率为45％～100％，平均84％。临床疗效优19例，良11例，中6例。骨性融合率达到100％。结论TLIF治疗腰椎间盘再突出临床效果满意，并发症少。

Surgical treatment for recurrent lumbar disc herniation by transforaminal lumbar interbody fusion

Objective To discuss the clinical effects of transforaminal lumbar interbody fusion (TLIF) for the treatment of recurrent lumbar disc herniation.Methods From April 2004 to August 2006, a total of 36 patients (25 male and 11 female with an mean age of 51.2 years old, ranging 37-68 years old) underwent TLIF operation for recurrent lumbar disc herniation. The operation segments were distributed as follows: L₃/L₄ in 2 cases, L₄/L₅ in 19 cases and L₅/S₁ in 15 cases. Preoperative and postoperative neurological status was evaluated by the Japanese Orthopedic Association (JOA) score system.Results After a 2-year follow-up, the mean JOA score was improved from 9.5 points before surgery to 24.6 points after surgery (P<0.01). The average improvement rate was 84% (ranging 45%-100%). Clinical outcome was excellent in 19 patients, good in 11 patients and fair in 6 patients. The fusion rate was 100% 2 years postoperatively. Conclusion The TLIF technique is an effective and safe treatment for recurrent lumbar disc herniation, with satisfactory outcome and less complications.