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

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, pos...

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Autores principales:	Wael Moussa, Wael Khedr
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2016
Materias:	Lumbar disc prolapsed posterior lumbar interbody fusion (PLIF) bilateral facet screw fixation laminectomy discectomy Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/2ac97e14ad6f41699609d49beab96b1e
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spelling	oai:doaj.org-article:2ac97e14ad6f41699609d49beab96b1e2021-12-02T11:31:24ZBilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc ProlapseDOI:10.21608/ESJ.2016.39882314-89502314-8969https://doaj.org/article/2ac97e14ad6f41699609d49beab96b1e2016-04-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_3988.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background 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. 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)Wael Moussa Wael KhedrEgyptian Spine AssociationarticleLumbar disc prolapsedposterior lumbar interbody fusion (PLIF)bilateral facet screw fixationlaminectomydiscectomyNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 18, Iss 1, Pp 39-51 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Lumbar disc prolapsed posterior lumbar interbody fusion (PLIF) bilateral facet screw fixation laminectomy discectomy Neurology. Diseases of the nervous system RC346-429
spellingShingle	Lumbar disc prolapsed posterior lumbar interbody fusion (PLIF) bilateral facet screw fixation laminectomy discectomy Neurology. Diseases of the nervous system RC346-429 Wael Moussa Wael Khedr Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse
description	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. 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)
format	article
author	Wael Moussa Wael Khedr
author_facet	Wael Moussa Wael Khedr
author_sort	Wael Moussa
title	Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse
title_short	Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse
title_full	Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse
title_fullStr	Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse
title_full_unstemmed	Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse
title_sort	bilateral lumbar facet screw fixation and posterior lumbar interbody fusion in lumbar disc prolapse
publisher	Egyptian Spine Association
publishDate	2016
url	https://doaj.org/article/2ac97e14ad6f41699609d49beab96b1e
work_keys_str_mv	AT waelmoussa bilaterallumbarfacetscrewfixationandposteriorlumbarinterbodyfusioninlumbardiscprolapse AT waelkhedr bilaterallumbarfacetscrewfixationandposteriorlumbarinterbodyfusioninlumbardiscprolapse
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Bilateral Lumbar Facet Screw Fixation and Posterior Lumbar Interbody Fusion in Lumbar Disc Prolapse

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