Comparative evaluation of functional outcome of discectomy versus discectomy with posterior lumbar interbody fusion for treatment of lumbar disc herniation

Authors

  • Mubarak Basha Imam Saheb Department of Orthopaedics and Traumatology, ESIC Medical College and PGIMSR, KK Nagar, Chennai, Tamil Nadu, India
  • Maheswaran Karattipalayam Saravanan Department of Orthopaedics and Traumatology, Govt. Kanyakumari Medical College, Asaripallam, Kanyakumari, Tamil Nadu, India
  • Joney Mandice Institute of Orthopaedics and Traumatology, Govt. Coimbatore Medical College, Coimbatore, Tamil Nadu, India
  • Vijay Krishnan Arcot Subramaniyan Assistant surgeon, Mettupalayam Government Hospital, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20192678

Keywords:

Lumbar disc herniation, PLIF, Discectomy

Abstract

Background: Lumbar disc herniation is the most common cause of low back pain and significant disability with economic impact too. Management of disc herniation is challenging, often confusing when surgical treatment is considered, because of frequent failures after surgery in many patients to relieve symptoms.

Methods: Our study was a prospective study conducted in Department of Orthopaedics, Coimbatore medical college. Thirty six patients operated for intervertebral disc herniation of lumbar spine from March 2015 to February 2017 were included in the study.

Results: VAS score was not significant between two groups, at one month, but at 6 months, PLIF group had better VAS score and was statistically significant. ODI scores showed a similar pattern.

Conclusions: Discectomy for symptomatic lumbar disc herniation is still the procedure of choice but with any subtle instability, then it should be combined with stabilisation like posterior lumbar interbody fusion.

Metrics

Metrics Loading ...

References

Atlas SJ, Keller RB, Chang Y, Deyo RA, Singer DE. Surgical and non surgical management of sciatic secondary to lumbar disc herniation. Spine. 2001;26:1179-87.

DePalma AF, Rothman RH. Surgery of lumbar spine. Clin Orthop. 1969;63:162-70.

Tay ECK, Chach PB: midline prolapse of lumbar intervertebral disc with compression of cauda equine. J Bone Joint Surg Br. 1979;61:43-6.

Hanley EN Jr, Shapiro DE. The development of low-back pain after excision of a lumbar disc. J Bone Joint Surg Am. 1989;71:719-21.

Toyone T, Tanaka T, Kato D, Kaneyama R. Low-back pain following surgery for lumbar disc herniation. A prospective study. J Bone Joint Surg Am. 2004;86:893-6.

Satoh I, Yonenobu K, Hosono N, Ohwada T, Fuji T, Yoshikawa H. Indication of posterior lumbar interbody fusion for lumbar disc herniation. J Spinal Disord Tech. 2006;19:104-8.

Cloward RB. The treatment of ruptured interveretebral discs by vertebral body fusion: Indications, operative technique, after care. J Neurosurg. 1953;10:154-68.

Parker SL, Mendenhall SK, Godil SS, Sivasubramanian P, Cahill K, Ziewacz J, et al. Incidence of low back pain after lumbar discectomy for herniated disc and its effect on patient-reported outcomes. Clin Orthop Relat Res. 2015;473(6):1988–99.

Maatta JH, Wadge S, MacGregor A, Karppinen J, Williams FM. vertebral endplate (modic) change is an independent risk factor for episodes of severe and disabling Low back pain. Spine. 2015;40(15):1187–93.

Cao P, Chen Z, Zheng Y, Wang Y, Jiang L, Yang Y, et al. Comparison of simple discectomy and instrumented posterior lumbar interbody fusion for treatment of lumbar disc herniation combined with Modic endplate changes. Chin Med J (Engl). 2014;127(15):2789–94.

DiPaola CP, Molinari RW Posterior lumbar interbody fusion. J Am Acad Orthop Surg. 2008;16(3):130-9.

Agazzi, S., Reverdin, A., May, D. Posterior lumbar interbody fusion with cages: an independent review of 71 cases. J Neurosurg. 1999;91:186–92.

Wang JC, Dailey AT, Mummaneni PV, Ghogawala Z, Resnick DK, Watters WC 3rd, et al. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: lumbar fusion for disc herniation and radiculopathy J Neurosurg Spine. 2014;21:48–53.

Fischer CR. Posterior Lumbar Fusion: Choice of Approach and Adjunct Techniques. J Am Acad Orthop Surg. 2014;22(8):503-11.

Zhang M, Pu F, Xu L, Zhang L, Yao J, Li D, et al. Long-term effects of placing one or two cages in instrumented posterior lumbar interbody fusion Int Orthop (SICOT). 2016;40:1239.

Downloads

Published

2019-06-27

How to Cite

Imam Saheb, M. B., Saravanan, M. K., Mandice, J., & Subramaniyan, V. K. A. (2019). Comparative evaluation of functional outcome of discectomy versus discectomy with posterior lumbar interbody fusion for treatment of lumbar disc herniation. International Journal of Research in Orthopaedics, 5(4), 651–655. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20192678

Issue

Section

Original Research Articles