Role of Posterior Lumbar Interbody Fusion in the Management of Lumbar Instability in Low- and Middle-Income Countries

Objective: This retrospective observational study aimed to determine the effectiveness of PLIF in the case of lumbar instability using the MacNab Criteria for functional recovery outcomes. Materials and Methods: This retrospective observational study included a total number of 21 patients who underwent the PLIF procedure at the Ali Institute of Neuroscience, Irfan General Hospital. Using the MacNab criteria the recovery outcomes of patients were assessed with demographic data and comorbidities recorded. Descriptive statistics including mean, median, and percentages were used to analyze the data, due to the small sample size no advanced inferential statistics tests were conducted. Results: The PLIF procedure showed great efficacy in correcting lumbar instability with 85% of patients reporting Good to Excellent recovery outcomes in terms of reduced lower back pain and lumbar instability. Leg pain has been improved in 90% of the cases while 9.5% of cases have reported delayed wound healing and foot drop. Overall, the complication rate was low with the PLIF procedure. These findings determine the effectiveness of PLIF in case of lumbar instability. Conclusion: PLIF is a significant surgical option for the correction of lumbar instability with high efficacy and low complication rate especially in low and middle-income countries. Further research with large sample sizes is recommended to show the long-term effectiveness of PLIF and to compare its effectiveness with other fusion techniques.