Comparative evaluation of functional outcome of discectomy and posterior lumbar interbody fusion for treatment of prolapse intervertebral disc

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. In the current study, we aimed to compare the functional outcomes of treating PIVD with discectomy alone and discectomy associated with posterior lumbar interbody fusion (PLIF).Materials and Methods: This study is randomised control study was conducted over 36 patients diagnosed with PIVD and operated for Discectomy (18 patients) or PLIF (18 patients) in Orthopaedic department, Geetanjali Medical College, Udaipur, Rajasthan between January 2019 to June 2020 and randomly allotted in two groups.To evaluate Functional outcomes using Japanese orthopedic score (JOA) and kirkaldy-willis criteria in every follow up at 2 week, 6 week, 3 month and 6 month.Results: Calculating the functional outcome by both the criteria in all follow ups, we concluded that in early follow up that is of second post op week, discectomy shows satisfactory outcome then that of PLIF group. In 6 month last follow up, PLIF group show satisfactory outcome then that of Discectomy patients groups and p value was 0.0042 which was significant. Out of 36 patients, one patient had dura rupture intraoperatively which was repaired simultaneously and one patient had surgical site infection which resolved later on, both patients were in discectomy group. Conclusions: Although both discectomy alone and discectomy with PLIF were associated with favorable mid-term results in treating patients with PIVD, however, we recommend using discectomy with PLIF for lower radicular pain for better long term results..