Posterior lumbar interbody fusion using single PEEK cage without pedicle screw fixation for lumbar disc herniation; Initial experience in Menoufia University Hospital

Abstract

Lumbar discectomy has successful initial clinical outcome; its long-term success rate decreases to 40–80% due to chronic low back pain and recurrent disc herniation. To evaluate the clinical results of Posterior Lumbar Interbody Fusion with a single unilateral stand-alone PEEK (Poly-Ether-Ether-Ketone) cage without pedicle screw fixation for single level lumbar disc herniation. A retrospective study of 40 patients (24 men and 16 women) with lumbar disc herniation, was conducted in the period from January 2016 through January 2021. The follow-up continued till December 2021. All patients suffered from single level lumbar disc herniation and were treated with Posterior Lumbar Interbody Fusion with a single unilateral stand-alone PEEK cage without pedicle screw fixation. The affected levels were L2–3 in 2 cases, L3–4 in 8 cases, L4–5 in 18 cases and L5–S1 in 12 cases. On 18th month follow-up, significant decrease in leg pain, LBP and ODI scores was detected (p < 0.001). This technique produced satisfying clinical enhancement in residual LBP, accepted radiological outcome such as maintaining the proper intervertebral disc space and prevention of recurrent disc herniation.