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| The curative effect of denervated bone resection combined with lamina fenestration and nucleotomy on lumbar disc herniation with the posterior vertebral body amputation |
| Yilixiati ZHANG Ning LIU Bo |
| Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing 100035, China |
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Abstract Objective To investigate the curative effect of denervated bone resection combined with lamina fenestration and nucleotomy (LOVE) on lumbar disc herniation (LDH) with the posterior vertebral body amputation. Methods From January 2013 to January 2014, patients treated in Beijing Jishuitan Hospital who had LDH with posterior edge separation were retrospectively analyzed. All patients underwent modified LOVE procedure. 56 patients had no nerve root compression by the posterior denervated bony. 56 patients were divided into two groups: trial group, 26 patients only underwent nucleotomy without resection of the posterior denervatied bony; and control group, 30 patients underwent nucleotomy with resection of the posterior denervated bony. All patients were followed up at least for 2 years. The operating time, intraoperative blood loss, preoperative and postoperative JOA score, VAS and intraoperative and postoperative complications between two groups were recorded. Results The operating time of trial group was significantly shorter than that of control group (P < 0.01). The blood loss of trial group was significantly less than that of control group (P < 0.01). There was no significant difference on VAS between two groups at different time points between groups (P ＞ 0.05). There was a statistically significant difference on VAS between two groups at different time points in the group (P < 0.01). There was no significant difference on JOA score between two groups at different time points between groups (P ＞ 0.05). There was a statistically significant difference on JOA score between two groups at different time points in the group (P < 0.01). There were no significant differences on curative effect between two groups after 3 months, 1 year and 2 years (P ＞ 0.05). Patients of two groups in 2-year follow-up cycle were no symptoms recurrence, no complications. Conclusion Modified LOVE in the treatment of LDH with vertebral fracture of the posterior margin, if the denervated bone hasn′t caused significant nerve root compression, neglect of denervated bone can achieve the same good curative effect, and can shorten operation time, reduce intraoperative blood loss compared with denervated bone resection.
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