Comparative Analysis of Functional Outcomes in L4-L5 Instability Treated with Bilateral Trans-Pedicular Fixation vs. Bilateral Trans-Pedicular Fixation with Posterior Lumbar Interbody Fusion

Background: Low back pain (LBP) is a leading cause of work-related disability, with the L4-L5 segment being the most affected in the lower lumber spine.Instability due to trauma, degeneration, or congenital factors causes severe pain and numbness.While conservative treatments exist, severe cases require Bilateral Trans-Pedicular Fixation or its advanced form, PLIF, for enhanced stability.Post-operative care is crucial to prevent complications.This study compares functional outcomes of Bilateral Trans-Pedicular Fixation versus Bilateral Trans-Pedicular Fixation with Posterior Lumbar Interbody Fusion for L4-L5 instability.Methods: This comparative experimental study involved 60 patients diagnosed with L4-L5 instability, randomly allocated into two groups.This study at MGM Medical College, Aurangabad, compared fixation with and without posterior lumbar interbody fusion in 60 patients with L4-L5 instability.Conducted from 1 st November 2014 to 31 st October 2016, it assessed clinical and radiological outcomes over six months using X-rays, MRIs, and statistical analysis.Results: This study was conducted among both groups with similar demographics, with no significant differences in comorbidities, trauma history, or neurological deficits.Group II (fixation with PLIF) had longer surgery duration, higher intraoperative blood loss, and superior functional recovery at 24 weeks.Radiological fusion was significantly higher in Group II (80% vs. 53.3%).Complication rates were similar in both groups (13.3%). Conclusion:This study concluded that PLIF showed superior fusion and functional recovery despite longer surgery time and higher blood loss.Both procedures had similar complication rates, making PLIF preferable for enhanced stability in L4-L5 instability cases.