Combination of Intraspine Interlaminar Device With Lumbar Discectomy in Patients With L5/S1 Disc Herniation

Abstract

Background. It is commonly recognized that interspinous spacers were not generally suitable for the application in L5-S1 level due to the short S1 spinous process.In this retrospective study, the feasibility and validity of the IntraSpine interlaminar device in the treatment of lumbar disc herniation on the L5/S1 level were evaluated.Methods. During the January 2018 and December 2018, a total of 30 patients, who were hospitalized in our hospital due to lumbar disc herniation (LDH) on the L5/S1 level, were included in the current study. The clinical symptoms before surgery, post-operation (3 days after surgery), 6 months after surgery, 12 months after surgery, and final follow-up were assessed using the back and leg visual analog scale (VAS), Oswestry disability index (ODI). Sagittal diameter of the lumbar spinal canal (SD), posterior disc height (PDH), left and right foramina height (LFH and RFH), left and right foramina width (LFW and RFW) were measured by sagittal reconstructions of CT scans. The range of motion (ROM) of L5-S1 level was estimated by lumbar dynamic X-ray images.Results. The back VAS, leg VAS, ODI, were significantly improved after surgery(P<0.05). The SD, PHD, LFH, RFH, LFW, and RFW after the operation and in the follow-up period were statistically different from those before surgery (P<0.05). The ROM of L5/S1 level at final follow-up was not statistically different from that before surgery (P = 0.299). 93.3% of patients demonstrated successful outcomes.Conclusions. The combination of IntraSpine interlaminar device with lumbar discectomy is an effective minimally invasive procedure for the treatment of L5/S1 disc herniation, which can delay and prevent the reduction of the disc height after discectomy in L5/S1 segment.