The herniated nucleosus pulposus(HNP) is the most common cause of back pain and sciatica in physically active ages. Previously, some authors reported several kinds of treatment modality for HNP. Of all the technique that have been introduced, we
have
used anterior interbody fusion. This technique seems to be the most suitable to HNP, not respond to conservative treatment, considering vertebral anatomy and biomechanics, we analyzed the cases of 114 patients who underwent anterior interbody
fusion for
HNP form November 1975 to April 1994, and evaluated bony fusion rate, fusing pattern, clinical results, and the factors affecting clinical results. The reported bony fusion rate and clinical results from respective authors were different.
Preoperatively, we reviewed symptom, physical sign and previous treatment modality, and performed plane roentgenogram and computed tomography (CT) scan with or without myelogram Postoperatively, we checked remained symptom and performed periodic
p0lane
roentgenogram, dynamogram, tomogram or CT scan for bony fusion state evaluation.
@ES The results were as follow:
@EN 1. Among 114 patients, 69(69.5%) were male and the most common age group was twenties(28.1%) and most common involved level was L4-5(64.0%).
2. In past history, 84 patients(73.7%) had a mediacation and physiotherapy ;and 8 patients(7.0%) had a history of laminectomy.
3. One hundred patients(87.7%) complaint back pain and radiating pain and In physical signs, 43 patients(37.7%) had motor weakness and 40 patients(35.1%) had sensory change, preoperatively.
4. In clinical result, 83.3% was excellent or good and In fusion, rate, complete fusion was 87.8% and the most common type of fusion pattern was type I (74.6%).
5. Satisfying clinical result had statistical correlation with union of grafted bone and fusion in state of maintained intervertebral disc height, respectively, by Fisher exact test(p<0.001).
In conclusion, Anterior interbody fusion is a recommendable method of treatment for lumbar herniated nucleus pulposus in physically active ages.
|