2012 Volume 21 Issue 2 Pages 118-127
Introduction: We usually perform the decompression surgery for lumbar degenerative spondylosis alone ; however, in cases of lumbar instability, lumbar degenerative spondylolisthesis and lumbar foraminal stenosis, posterior fusion surgery may also be selected. We have performed mini-open TLIF as a minimally invasive spinal surgery since 2006. We discuss our surgical method and operative results mainly concerning spinal column function. Materials and Methods: We have operated on 64 cases of lumbar degenerative disease by mini-open TLIF. In this procedure, the skin is linearly incised about 6 cm long. The neural decompression is performed via hemi-fenestration. A unilateral inferior facetectomy at the open side is performed and intervertebral fusion via the intervertebral foramen is achieved. At the contralateral side, the pedicle screws are inserted by an intramuscular approach between the multifidus muscle and longissimus muscle. We evaluated the clinical results and postoperative spinal column function. Results: The affected vertebral height increases significantly just after the operation ; however, correction loss was seen one year after the operation. The correction of slippage and lordosis between the affected vertebrae was maintained one year after the operation. As to the total balance of the spine, the postoperative C7 plumb line tended to move posteriorly, which meant an improvement in spinal sagittal balance. Discussion and Conclusion: The importance of spinal balance has recently been discussed. Spinal deformity such as severe kyphosis of the total spine may induce a restricted daily life and leas to a poor prognosis by respiratory and gastrointestinal problems. Finally, since we have selected short-segmental fusion, which must be inspected in the points of total spinal balance in the future.