Surgical outcomes of posterolateral and anterolateral approaches to thoracolumbar intervertebral disc herniation

Objective To compare the clinical outcomes of posterolateral and anterolateral approaches to thoracolumbar intervertebral disc herniation. Methods Forty-eight patients with thoracolumbar intervertebral disc protrusion（T10-L2） admitted to our hospital from January 2000 to December 2010 were retrospectively analyzed in this study.Of these patients,33 underwent intervertebral resection and fusion through posterolateral transforminal approach,15 underwent intervertebral resection and fusion through anterolateral retroperitoneal approach.Their operation time,blood loss,and postoperative complications were recorded,and their subjective outcomes were assessed according to the oswestry disability index（ODI） scores before operation,and 3 and 12 months after operation. Results The patients were followed up for 6-24 months（mean 15.2 months）.No significant difference was found in the operation time,blood loss and ODI scores between the two groups 12 months after operation（P＞0.05）.The ODI scores were significantly lower 3 and 12 months after operation than before operation（P＜0.05）.The complications of posterolateral approach were less than those of anterolateral approach.The intervertebral fusion rate was 96% in two groups 12 months after operation. Conclusion Both posterolateral and anterolateral approaches are the effective surgical procedures for thoracolumbar intervertebral disc herniation.However,the complications of posterolateral transforminal approach are less than those of anterolateral retroperitoneal approach.