Impact Of Lumbar Pedicular Screw Fixation And Postero-Lateral Fusion On Recurrence Rates In Cases Of Primary Lumbar Disc Prolapse

摘要

Background: Patients suffering from a lumbar herniated disc will typically present with signs and symptoms consistent withradiculopathy. The surgical alternative of choice remains a lumbar discectomy, but fusions have been performed for bothprimary and recurrent disc herniations.Aim: In our study we are providing our experience to evaluate the impact of trans-pedicular screw fixation and postero-laterallumbar spine fusion on the recurrence rates of lumbar disc herniation.Methods: A retrospective study on 45 patients with primary lumbar disc prolapse presented with typical radiculopathy.Results: Out of 45 patients, 20 patients (Group A) underwent simple classic discectomy via fenestration or laminectomy. Forthe other 25 patients (Group B), we performed additional postero-lateral fixation and fusion with rods, screws and bone graft. Inour study the rate of recurrence of disc prolapse was much reduced by posterolateral fixation and fusion with a radiologicalpreserved disc height. Fixation does not only prevent recurrence of discectomy but it alters the degenerative process andmaintains lumbar stability.Conclusion: Simple lumbar discectomy remains the surgery of choice for lumbar disc prolapse, however, our study proves thatlumbar fixation and fusion along with lumbar discectomy reduces the incidence of recurrence of disc prolapse and of lumbarinstability.