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. 2009 Feb;33(1):197-201.
doi: 10.1007/s00264-008-0531-1. Epub 2008 Mar 21.

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

Zhiming Chen  1 , Jie Zhao, Aigang Liu, Jiandong Yuan, Zhonghai Li
Affiliations

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

Zhiming Chen et al. Int Orthop. 2009 Feb.

Abstract
in English, French

Between 2001 and 2005, 43 patients (average age 54.2, range 36-68 years) with recurrent lumbar disc herniation underwent reoperation with the transforaminal lumbar interbody fusion (TLIF) technique at our unit. All cases were followed up for 24-72 months (mean 45 months) and graded using the Japanese Orthopaedic Association (JOA) score system pre- and post-operation and during the follow-up period. The leg pain of all patients was relieved significantly within one month postoperatively. The mean JOA score was improved from 9.3 before surgery to 25.0 at the final follow-up visit (P<0.0001). The average recovery rate was 86.0% (range 52-100%). General clinical outcome was excellent in 23 (53.5%) patients, good in 14 (32.6%) and fair in 6 (13.9%). The fusion rate was 100% two years postoperatively. Three patients (7%) had transient neurological deficits, which resolved completely within 3 months. There were no major complications. We, therefore, believe the TLIF technique to be an effective procedure with satisfactory clinical results for the treatment of recurrent lumbar disc herniation.

Entre 2001 et 2005, 43 patients (âge moyen 54,2 ans entre 36 à 68 ans) ont bénéficié d’une réintervention chirurgicale avec arthrodèse inter corporéale par technique transforaminale pour récidive de hernie discale lombaire. Tous ces patients ont été suivis en moyenne pendant 45 mois et évalués selon le score de la JOA en pré et post opératoire. Les douleurs des membres de tous ces patients ont été nettement améliorées dans le premier mois post opératoire. Le score de la JOA a été également améliorée de 9,3 avant l’intervention à 25 lors de la dernière revue de ces malades (P<0,0001). Le taux moyen de récupération a été de 86% (52 à 100%). L’évolution clinique générale a été excellente chez 23 patients (53,5%), bonne chez 14 patients (32,6%) et médiocre chez 6 patients (13,9%). Le taux de fusion a été de 100% en post opératoire. 3 patients (7%) ont eu des troubles neurologiques transitoires qui ont complètement régressé dans les trois mois. Il n’y a pas eu de complications majeures. L’étude technique TLIF est une technique efficace qui nous donne satisfaction dans le traitement des récidives de hernies discales lombaires.

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Figures

Fig. 1a–c
Fig. 1a–c
A 40-year-old female with L4–5 recurrent disc herniation. She had undergone discectomy with laminotomy because of L4–5 disc herniation 11 years previously. a Preoperative sagittal magnetic resonance image (MRI) showing L4–5 disc reherniation. b Preoperative axial MRI showing L4–5 disc reherniation and left nerve root compression. c Preoperative lateral X-ray showing L4–5 disc space narrowed
Fig. 2
Fig. 2
Postoperative plain lateral radiograph showing L4–5 instrumented with the transforaminal lumbar interbody fusion (TLIF) technique; the disc height was restored
Fig. 3
Fig. 3
Two years post-operatively lateral X-ray showing L4–5 solid fusion; the disc height was maintained
See this image and copyright information in PMC

References

    1. Barrick WT, Schofferman JA, Reynolds JB, et al. Anterior lumbar fusion improves discogenic pain at levels of prior posterolateral fusion. Spine. 2000;25:853–857. doi: 10.1097/00007632-200004010-00014. - DOI - PubMed
    1. Cinotti G, Roysam GS, Eisenstein SM, et al. Ipsilateral recurrent lumbar disc herniation. A prospective, controlled study. J Bone Joint Surg Br. 1998;80:825–832. doi: 10.1302/0301-620X.80B5.8540. - DOI - PubMed
    1. Cinotti G, Gumina S, Giannicola G, et al. Contralateral recurrent lumbar disc herniation. Results of discectomy compared with those in primary herniation. Spine. 1999;24:800–806. doi: 10.1097/00007632-199904150-00012. - DOI - PubMed
    1. Ebeling U, Kalbarcyk H, Reulen HJ. Microsurgical reoperation following lumbar disc surgery. Timing, surgical findings, and outcome in 92 patients. J Neurosurg. 1989;70:397–404. doi: 10.3171/jns.1989.70.3.0397. - DOI - PubMed
    1. Fandiño J, Botana C, Viladrich A, et al. Reoperation after lumbar disc surgery: results in 130 cases. Acta Neurochir (Wien) 1993;122:102–104. doi: 10.1007/BF01446994. - DOI - PubMed