A COMPARATIVE STUDY OF TRADITIONAL LUMBAR DISCECTOMY VS LUMBAR DISCECTOMY WITH CAGE FIXATION

Abstract

Background:

Lumbar disc herniation is a common cause of lower back and radicular pain, often necessitating surgical intervention when conservative treatments fail. Traditional lumbar discectomy (TLD) is widely practiced and involves the removal of the herniated disc fragment to relieve nerve root compression. However, concerns remain about postoperative segmental instability, recurrent disc herniation and long-term degenerative changes. The effectiveness of cage-assisted discectomy in improving clinical outcomes, reducing recurrence and maintaining spinal alignment remains an area of ongoing debate.

Objectives:

1-  To compare postoperative pain relief between traditional lumbar discectomy and lumbar discectomy with cage fixation.

Methodology:

This prospective, comparative study was conducted over a 24-month period from January 2023 to December 2024 at Sughra Shafi Medical Complex Narowal. A total of 80 patients diagnosed with single-level lumbar disc herniation, refractory to at least six weeks of conservative management were enrolled and equally divided into two groups: Group A (n = 40) Underwent traditional lumbar discectomy (TLD) and Group B (n = 40) Underwent lumbar discectomy with interbody cage fixation (LDCF). Data were analyzed using appropriate statistical tests, with p < 0.05 considered statistically significant.

Results:

A total of 80 patients were included in the study, with 40 undergoing traditional lumbar discectomy (Group A) and 40 undergoing lumbar discectomy with cage fixation (Group B). The demographic characteristics, including age, sex distribution, and baseline clinical parameters, were comparable between the two groups, with no statistically significant differences (p > 0.05). Postoperative pain relief, as measured by the Visual Analogue Scale (VAS) and Oswestry Disability Index and showed a statistically significant improvement in both groups

Conclusion:

Lumbar discectomy with cage fixation offers superior outcomes in terms of pain relief, functional recovery, and spinal stability when compared to traditional discectomy alone. Although the procedure involves longer operative time and higher initial cost, the benefits of reduced recurrence and better long-term outcomes make it a valuable surgical option, particularly in patients at risk of instability. However careful patient selection and surgical expertise are essential to maximize benefits and minimize complications.