title: Analytical comparison study of the clinical and radiological outcome of spine fixation using posterolateral, posterior lumber interbody and transforaminal lumber interbody spinal fixation techniques to treat lumber spine degenerative disc disease.
abstract: BACKGROUND
  Degenerative disc disease is a common cause of chronic and disabling back pain that requires surgical intervention, posterolateral and posterior instrumental fixation (PLF), posterior lumber interbody fusion (PLIF) and transforaminal lumber interbody fusion (TLIF) are the techniques used to deal with such a problem.
  
  
  OBJECTIVE
  To compare the clinical and radiological outcome of the variable surgical techniques used to deal with Lumber degenerative disc disease and to recommend the technique of choice.
  
  
  METHODS
  120 patients were treated between 2003 and 2010 at king Abdullah university hospital for lumber disc disease. The patients were divided into three groups: Group I (PLF n = 30 [59 levels]); Group II (PLIF n = 40 [70 levels]); and Group III (TLIF n = 50 [96 levels]). All patients had the same pre- and postoperative clinical and radiological evaluations (using Stanford score and local criteria and Oswestry Disability Index [ODI],). All cases had three months and then yearly for five years follow ups.
  
  
  RESULTS
  There was no observed difference in the rates of intra-operative complications (Group I: 10 %; Group II: 8 %; Group III: 14 %; p = 0.566) and postoperative complications (Group I: 13.3 %, Group II:17.5 %, Group III: 18 % with p = 0.332). Among the groups. There was a vital decrease in the ODI scores over time (p < 0.005) but no major difference among the groups at different follow-up times. Radiographic fusion rates for Groups I, II and III were 90 %, 92.5 % and 94 %, respectively.
  
  
  CONCLUSIONS
  The surgical outcome of PLF, PLIF and TLIF used to treat degenerative disc disease is almost similar, there is no significant differences observed in complications and clinical outcomes. However, TILF may have better radiological outcome.
authors.affiliation: Department of Neuroscience/ Division of Neurosurgery, Level 7A. King Abdullah University Hospital, Jordan University of Science and Technology, Irbid-Amman Street, P.O.box 3030, Irbid, Jordan.
authors.forename: Moh'd M
authors.initials: MM
authors.lastname: Al Barbarawi
authors.affiliation: Department of orthopeadic, Level 8A. King Abdullah University Hospital, Jordan University of Science and Technology, Irbid-Amman Street, P.O.box 3030, Irbid, Jordan.
authors.forename: Ziad M
authors.initials: ZM
authors.lastname: Audat
authors.affiliation: Department of Anatomy, Faculty of medicine, Jordan University of Science and Technology, Irbid-Amman Street, P.O.box 3030, Irbid, Jordan.
authors.forename: Mohammed Z
authors.initials: MZ
authors.lastname: Allouh
keywords: Degenerative disc disease (DDD); Posterior lumber interbody fusion (PLIF); Posterolateral fusion (PLF); Spinal fixation; Transforaminal lumber interbody fusion (TILF)