Analysis Of The Curative Effect Of Tlif Operation On High Lumbar Intervertebral Disc Herniation

Objective: The anatomical features of the higher lumbar spine and its ancillary structures are different than that of the lower lumbar spine,including the size of the vertebral body,the shape and size of the vertebral canal,the width of the lamina,the contents of the spinal canal and the length and shape of the nerve root.therefore all of these features make the higher lumbar spine different from the other vertebral bodies.Out of all patients with lumbar disc herniation,patients with high lumbar disc herniation accounted for very small proportion and most of the symptoms were significantly serious than lower lumber disc herniation but were not very typical therefore causing difficulties in the diagnosis and treatment process.As one of the routine operations for the treatment of lumbar disc surgery,TLIF surgery is also suitable for patients with high lumbar disc herniation.However,there are very few clinical evaluations and analysis on the surgical treatment of TLIF.Therefore,the author retrospectively analyzed the short-term and medium-term effects of transforaminal lumbar interbody fusion(TLIF)for the treatment of high lumbar disc herniation.Methods: From 2012 to 2017,patients undergoing TLIF(34 cases)with high lumbar disc herniation were retrospectively analyzed in our hospital.The clinical data of each group(including preoperative symptoms,Positive signs,postoperative symptoms and postoperative physical examination)and scoring results(including JOA,ODI score),the preoperative and postoperative 1 year,3 years after the operation of comparative statistical data to assess TLIF Surgery in the treatment of high lumbar disc herniation in patients with short-term,medium-term efficacy.Results: All patients underwent JOA and ODI before surgery.13 patients(2012-2014) were followed up for 1 year and 3 years after operation and 34patients(2012-2017)were followed up for about 1 year after operation.The preoperative JOA score was 10.05±1.763(11.04±1.865),the postoperative first year and third year scores were 24.34±2.158(23.65±1.730),22.12±2.633.The ODI preoperative score was 62.35±4.100(64.69±4.019),The postoperative first year and third year scores were16.28±3.080(17.36±1.030),18.25±2.429 There were significant differences in the preoperative and postoperative first year and third year follow-up results(P <0.05),but there was no significant difference in the follow-up results between first year postoperatively and third year postoperative(P> 0.05).There were various degrees of relievement of preoperative symptoms in the patients that underwent TLIF surgery and varying degree of improvement in the positive physical preoperative symptoms.some patients had poor healing of postoperative incision,deep incision pain and other complications which healed smoothly after the symptomatic treatment.Conclusion: TLIF surgery for patients with high lumbar disc herniation in the short-term and mid-term effect is quite affirmative.