Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse

Abstract

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 syndrome can 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.