Functional Outcome of Prolapsed Intervertebral Disc Disease at Lumbosacral Spine in Patient Treated with Laminectomy Discectomy with Pedicle Screw Fixation Verses without Pedicle Screw Fixation: A Prospective Comparative Study

Background: Laminectomy and discectomy are established surgical treatments for Prolapsed intervertebral disc (PIVD), aiming to decompress neural structures. However, routine addition of pedicle screw fixation in the absence of overt spinal instability remains a subject of ongoing debate. This study aimed to evaluate and compare functional outcomes in patients presenting with PIVD treated by laminectomy and discectomy without or with concomitant pedicle screw fixation. Materials and Methods: This comparative study was conducted in the Department of Orthopaedics, for a period of 18 months, which included 96 patients divided into two treatment groups of laminectomy and discectomy: (a) Without pedicle screw fixation, and (b) With pedicle screw fixation. Patients were followed up at 1, 3, and 6 months for post-operative functional outcome of patients, as assessed by the VAS scores for low back pain and leg pain, Oswestry Low Back Pain Disability Questionnaire, JOA scores, Roland-Morris Low Back Pain and Disability Questionnaire, and muscle power grading. Results: There was statistically significant improvement in the NPRS scores from baseline to 6-month follow-up period in both the study groups (p<0.001). Additionally, there was improvement in other outcome parameters in both study groups from pre-operative to 6-month follow-up, but the difference was not statistically significant (p>0.05). Conclusion: The study concluded that routine application of pedicle screw fixation may not be essential for this specific patient demographic, potentially enabling a less invasive surgical approach.