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Comparison of simple discectomy and instrumented posterior lumbar interbody fusion for treatment of lumbar disc herniation combined with Modic endplate changes

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Chinese Medical Journal 2014年第15期127卷 2789-2794页

作者： Cao Peng Chen Zhe Zheng Yuehuan Wang Yuren Jiang Leisheng Yang Yaoqi Zhuang Chengyu Liang Yu Zheng Tao Gong Yaocheng Zhang Xingkai Wu Wenjian Qiu Shijing Department of Orthopaedics Ruijin Hospital School of Medicine Jiao Tong University and Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases with Integrated Chinese- Western Medicine Shanghai Institute of Traumatology and Orthopaedics Shanghai 200025 China Shanghai Institute of Traumatology and Orthopaedics Shanghai200025 China Department of Orthopaedics Xinhua Hospital School of MedicineJiao Tong University Shanghai 200092 China

Background The purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and instrumented posterior lumbar interbody fusion （iPLIF） in patients with lumbar disc herniation and Modic endplate *** hypothesis was that iPLIF could provide better outcome for patients with refractory lumbar disc herniation and Modic changes （LDH-MC）.Methods Ninety-one patients with single-segment LDH-MC were *** patients experienced low back pain as well as radicular leg pain,and low back pain was more severe than leg ***-seven patients were treated with discectomy and 44 were treated with iPLIE The outcomes of both low back pain and radicular leg pain using visual analogue scale （VAS） as well as the clinical outcome related to low back pain using Japanese Orthopaedic Association （JOA） score were assessed before and 18 months after surgery,*** Both low back and leg pain were significantly improved 18 months after simple discectomy and iPLIE Compared to patients undergoing simple discectomy,low back pain was significantly reduced in patients undergoing iPLIE but there was no significant difference in leg pain between two *** fusion was achieved in all patients who underwent *** In patients with LDH-MC,iPLIF can yield significantly superior outcome on the relief of low back pain compared to simple *** discectomy can relieve radicular leg pain as efficient as iPLIE Accordingly,iPLIF seems to be a reliable treatment for patients with LDH-MC and predominant low back pain.

关键词： lumbar disc herniation modic changes discectomy, instrumented posterior lumbar interbody fusion low back pain

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