Subject Area

Degenerative, Lumbosacral spine

Document Type

Clinical Study


Background Data: Lumbar disc prolapse is a common neurosurgical diagnosis. A trial of medical treatment, bed rest and physiotherapy is tried at first. Surgical treatment is resorted to if conservative treatment fails. However, postoperative complications including recurrent lumbar disc prolapse, postlaminectomy spondylolisthesis and failed back syndromecan occur. This is usually caused by instability at the discectomy level. In a trial to reduce these complications, we will use posterior lumbar interbody fusion together with bilateral facet screw fixation implanted during discectomy to reduce postoperative instability. Purpose: To study the effect of posterior lumbar interbody fusion with bilateral facet screw fixation to decrease the incidence of postoperative complications. Study Design: A prospective randomized controlled trial including 40 patients. Patients and Methods: Forty patients diagnosed with lumbar disc prolapse causing sciatic pain with or without lower limb weakness not responding to conservative treatment were included in the study. Twenty patients(group A) was submitted to PLIF together with bilateral facet screw fixation after having conventional lumbar laminectomy and discectomy, while 20 other patients (group B) was submitted only to conventional lumbar laminectomy and discectomy and will be used as controls. Results: None of group A patients had recurrent LDP, while 8 patient of group B had a significant recurrence at the same level that required surgery (P=0.0364). At 2 years follow-up, 3 patients ofgroup A and 14 of group B had persistent LBP, the difference being statistically significant (P=0.0168).Conclusion: Combined posterior lumbar interbody fusion and bilateral facet screw fixation in lumbar disc prolapse is technically easy to be done and significantly reduce the incidence of recurrent lumbar disc prolapsed, as well as the postoperative lumbar instability and chronic low back pain. (2016ESJ108)


Key words: Lumbar disc prolapsed, posterior lumbar interbody fusion (PLIF), bilateral facet screw fixation, laminectomy and discectomy