Disc herniation in the thoracolumbar junction treated by minimally invasive transforaminal interbody fusion surgery

Abstract

Minimally invasive surgery-transforaminal lumbar interbody fusion (MIS-TLIF) has demonstrated efficacy in the treatment of lumbar degenerative diseases. Use of this procedure for thoracolumbar junction disc herniation remains challenging. Reports concerning MIS-TLIF at the thoracolumbar junction are rare. Thus, we performed a retrospective analysis of the clinical outcomes of 10 patients with thoracolumbar junction disc herniation treated by MIS-TLIF between December 2007 and October 2010. The purpose of this study was to investigate the efficacy and safety of MIS-TLIF for disc herniation in the thoracolumbar junction. Clinical and radiological data were collected and analyzed. Fusion levels included T12–L1 (two patients), L1–L2 (four patients) and L2–L3 (four patients). Clinical outcome was assessed using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). The average follow-up period was 39.2months, with a minimum of 24months. The mean±standard error of the mean of the operative time, intraoperative blood loss, and x-ray exposure were 128±36minutes, 204±35mL, and 43±12seconds, respectively. The VAS for back and leg pain decreased significantly postoperatively from 6.4±2.7 to 1.5±0.6 (p<0.01), and from 7.1±2.4 to 1.3±0.4 (p<0.01) respectively, as did the ODI from 39.3±11.2 to 16.5±4.7 (p<0.01). Bone fusion was observed in eight patients. There were no other major complications at last follow-up. MIS-TIF is a safe and effective procedure for disc herniation in the thoracolumbar junction. Occurrence of non-union is relatively high compared to previous findings.