요추부 추간판내장증에서 추간판제거술과 후방 추체간유합술을 이용한 치료 - 최소 3년 추시 -

Abstract

To evaluate the efficacy of disc excision and posterior lumbar interbody fusion (PLIF) in patients of internal disc derangement with chronic persistent low back pain that conservative treatment was not effective, this study reviewed 40 patients retrospectively who had been followed-up for at least 3 years among 89 patients underwent disc excision and PLIF from July 1999 to February 2005. Their clinical outcomes were evaluated by the method of Schecher et al. The fusion result and the degenerative change of proximal and distal adjacent segments were evaluated by radiologic methods. 31 cases (77.5%) showed satisfactory clinical outcomes. Fusion rate was 87.5%. However, five cases (12.5%) resulted in nonunion that was treated with anterior fusion in three cases. Proximal segmental degenerative change occurred in nine cases (22.5%), but there was no distal segmental degenerative change. two cases (5%) showed dural tear for which primary suture was done, and neurologic symptoms on three cases (7.5%) were improved without specific problems. In patients of internal disc derangement that conservative treatment was not effective, the result of the both disc excision and PLIF was satisfactory. It is suggested that disc excision and PLIF for internal disc derangement patients is an effective modality of treatments.