Posterior articular process approach for the treatment of upper lumbar disc herniation

項良碧(Xiang Liangbi，Dept Orthop，Gen Hosp Shenyang Mil Command，Shengyang 110016)…∥Chin J Clin Basic Orthop Res.－2010，2(3).－204～207

Posterior articular process approach for the treatment of upper lumbar disc herniation

項良碧(Xiang Liangbi，Dept Orthop，Gen Hosp Shenyang Mil Command，Shengyang 110016)…∥Chin J Clin Basic Orthop Res.－2010，2(3).－204～207

ObjectiveTo investigate the feasibility and surgical effects of posterior articular process approach for the treatment of L1-L3 lumbar disc herniation.MethodsA retrospective study，of 17 patients with upper lumbar intervertebml disc herniation was carried out，m which 13 patients were treated with unilateral articular process excision and nucleus pulposus resection，lumbar interbody fusion and pedicle screw internal fixation while 4 patients were treated with bilateral articular process excision and nucleus pulposus resection，lumbar interbody fusion and pedicle screw internal fixation.ResultsAll patients had an average follow-up period of 14 months(12－16 months).Preoperative Oswestry dysfunction index(ODD was(88.1 4 ± 5.8)%and postoperative ODI was(47.9 ±4.9)%respectively，which showed significant improvement(t=14.754，P=0.003);According to Japanese Orthopaedic Association(JOA)scores，the total excellent-to-good rate was 94.1%(16/17).No injuries of spinal cord，nerve root and blood vessels occurred during the operation，and X-ray showed that all cases had bone graft fusion without internal fixation failure.ConclusionOperation through posterior articular process approach is a feasible surgical method for upper lumbar disc herniation with the advantages of minimal invasion，less complications and satisfactory clinical effects.9 refs，1 fig.

(Authors)