Disc Excision and Posterior Lumbar Interbody Fusion for Internal Disc Derangement

Chul Hyung Kang; Jae Hong Chun

doi:10.4184/jkss.2001.8.1.62

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Kang and Chun: Disc Excision and Posterior Lumbar Interbody Fusion for Internal Disc Derangement

Original Article

Journal of Korean Spine Surg 2001;8(1):62-67.

Published online: 12 February 2001

DOI: https://doi.org/10.4184/jkss.2001.8.1.62

Disc Excision and Posterior Lumbar Interbody Fusion for Internal Disc Derangement

Chul Hyung Kang, M.D., Jae Hong Chun, M.D.

Department of Orthopedic Surgery, Keimyung University, School of Medicine, Taegu, Korea

Address reprint requests to Chul Hyung Kang, M.D. Department of Orthopedic Surgery, Keimyung University, School of Medicine, Taegu, Korea #194 Dongsan-dong, Joong-gu, Taegu, 700-712, Korea Tel : 82-53-250-7206, Fax : 82-53-250-7205, E-mail : chkang@dsmc.or.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

This study reviewed prospectively 15 patients with chronic persistent low back pain who were treated with disc excision and posterior lumbar interbody fusion(PLIF). Outcomes of treatment were evaluated by a follow- up interview and x-ray studies.

Objectives

To evaluate the efficacy of surgical treatment of patients with chronic persistent low back pain resulting from internal disc derangement (IDD) that does not respond to conservative treatments.

Summary of Literature Review

Chronic persistent low back pain resisting to all known modalities of conservative treatments represents a difficult problem. The efficacy of any specific treatment methods for this group of patients is controversial.

Materials and Methods

Between 1994 and 2000, 15 patients were treated with disc excision and PLIF at Keimyung University Hospital from 1994 to 2000. The clinical outcomes were evaluated by postoperative follow- up interviews, and the fusion results were evaluated by x-ray studies.

Results

All patients responded properly to the follow- up evaluation. 66.6% of the patients had satisfactory results(13.3% excellent, 53.3% good, 26.7% fair, 6.7% poor), and a successful fusion was obtained in all of the patients. Conclusion : These results suggest that disc excision and PLIF for IDD patients is effective modality in treatment of IDD.

Keywords: Internal disc derangement, Disc excision, Posterior lumbar interbody fusion.

REFERENCES

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Fig. 1A-B.

This simple x-ray shows posterior lumbar interbody fusion and posterior instrumentation on L5-S1 level.(A: anteroposter-ial view. B: lateral view)

Table 1.

Neil's criteria for clinical evaluation of surgical outcome

Result	Pain intensity	Medication	Activity
Excellent	None or occasional	None	Prior job, no restrictions
Good	Mild	Occasional NSAIDs	Prior job, minimal restrictions
Fair	Frequent, moderate	Frequent narcotics	Light duty, less strenuous social and recreational activities
Poor	Severe, constant	Continuous narcotics	Retired from work, severe restrictions

Table 2.

Outcomes of treatment results.

Outcomes	No. of Patients(%)	Total(%)
Satisfactory
Excellent	2 (13.3)	66.6
Good	8 (53.3)
Unsatisfactory
Fair	4 (26.7)	33.4
Poor	1 (16.7)

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