Comparative Study between the Outcomes of Posterior Lumbar Interbody Fusion Combined with Transpedicular Screws versus Transpedicular Screws Alone in Recurrent Lumbar Disc Prolapse

Abstract

Background: Recurrent lubmer disc herniation is a challenge facing neurosurgeons. Disectomy is the rule. However, fusion was emerged as an alternative. No consensus for standard fusion technique is reached yet. Aim of the work: to investigate the outcome of posterior interbody fusion combined with transpedicular screws versus the transpedicular screws alone, for recurrent disc herniation. Patients and Methods: Thirty patietns with recurrent disc prolapse were included and divided into two equal groups. Group A: interbody fusion with transpedicular screw, and Group B: transpedicular screws alone). All were evaluated by history taking, clinical examination and laboratory and radiological investigations. Pain assessed by visual analogue scle and oswestry disability index used to assess associated disabilty. Intraoperative data were document and patients followed up postoperatively for six months, by the same methods used for preoperative evaluation. Results: Both groups were comparable regarding all studied variables, except significant increase of symptoms duration in group A than group B (4.45 ± 1.09 vs 3.28 ± 0.924 months, respectively). Also, there was significant low back pain reduction in A than B group (1.23 ± 0.586 vs 1.72 ± 0.643), at the six months of follow up. Finally, in both groups, low back and radicular pain was significantly reduced when compared to preoperative values. Conclusion: The usage of the lumbar fusion for the treatment of recurrent disc prolapse is an effective, and safe management option. It associated with more low back pain reduction.