Clinical Observations For Recurrent Lumbar Disc Herniation Treated With Posteiror Lumbar Interbody Fusion

Objective: To investigate the clinical outcomes of posterior lumbar interbody fusionfor recurrent lumbar disc herniation.Methods: Form October2010-March2013,a total of30cases suffering formrecurrent lumbar disc herniation and undergoing surgical intervention was retrospectivelyanalyzed.There were18males and12females,with a mean age of59.3years(range,43-86years).The interval between first operation and recurrence was1-18years(mean,4.9years).Course of the disease was2-12months(mean,5months).A total of30segments wasinvolved,including L3/4in2cases,L4/5in19cases,L5/S1in9cases.All the casesunderwent posterior lumbar interbody fusion using cage for the reoperation.Visualanalogue scale(VAS) score system was used to evaluate back pain at pre-operation、post-operation1month、3months、6months and12months after surgery.JOA(29) scoresystem was used to evaluate the pre-operative and post-operative1month、3months、6months and12months score and improvement rate, which was used to evaluate clinicaleffects.Results: There were6cases that spinal dura mater was teared and repaired during theoperation,there was1case that occur leakage of cerebrospinal fluid after operation.Theoperation time was2-4hours(mean,2.8hours), blood loss was400-700ml(mean,537ml).VAS score was7.40±0.77at pre-operation,analysis of data showed statisticalsignificance between pre-operation and1month post-operation(P <0.05) as well asbetween3months、6months and12months post-operation (P <0.05).The mean score ofJOA was9.80±2.41at pre-operation,analysis of data showed statistical significancebetween pre-operation and1month post-operation(P <0.05) as well as between3months、6months and12months post-operation(P<0.05).All patients were followed up for12-18 months(mean,13.7months), and all cases got lumbocrural pain relieved effectively andwell bony fusion.Interbody fusion cages stayed with normal location.No loosening orbreakage happened to pedicle screws and recurrent situation was noted.Conclusion: The application of posterior lumbar interbody fusion in the treatment ofpatients with recurrent lumbar disc herniation can obviously relieve the symptoms andimprove the functional disturbances.Meanwhile,there was no serious complicationsoccurred and is regarded as one of the ideal method of treatment of recurrent lumbar discherniation.But long-term efficacy remains to be seen.