الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Degenerative disc disease of the lumber spine is a serious problem that causes varying degrees of disability. Lower back pain, sciatica, paraesthesia, weakness and intermittent claudication are the main symptoms caused by degeneration. Many surgical techniques are used in treating this problem.
Spinal arthrodesis (fusion) is one option for the management of debilitating degenerative disorders of the lumbar spine.
The usual spinal fusion procedures are instrumented posterolateral fusion (PLF) and lumbar interbody fusion, including anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) by open discectomy.
Nevertheless treatment strategies have moved towards global fusion based on the theoretical point of view that restoration of lordosis, sagittal balance, and neuroforaminal decompression due to restoration of the disc height would result in better functional outcomes.
Many disc spacers are used for interbody fusion, for instance Titanium cages, polyetheretherketone (PEEK) cages, and Allografts. Titanium has the best rigidity among interbody devices, which has been reported to be the leading cause of subsidence and loss of disc space height. Femoral head allografts have the benefits of serving as a scaffolding material for bone growth, but also, subsidence and disc space collapse are reported.
The PEEK cages were popularized because of its radiolucency, low rigidity, and less subsidence as compared with the titanium and allografts spacers. PEEK cages have a modulus of elasticity near to that of cortical bones.
Previous studies have reported several complications of synthetic cages, including risk for subsidence and corrosion.
To reduce the risk of these complications and still obtain good contact between the intervertebral spacers, an alternative graft made as a strut graft to better achieve fusion is introduced in the current study.
In the present study, clinical and radiological outcomes were compared in 40 patients done PLIF in two groups, group (A),20 patients done PLIF with a strut autograft from the lamina versus group (B), 20 patients done PLIF with PEEK cage.
This study has shown that both groups have similar clinical outcome parameters including VAS (visual analogue scale) and ODI(Oswestery disability index). Disc height as well as segmental lordotic angle are restored and preserved throughout the current study.
In conclusion, satisfactory fusion rates and restoration of intervertebral height and segmental lordosis can be achieved and maintained in PLIF using either a strut graft made of bone taken from the patient’s laminae or a PEEK cage with a local bone graft. Our results suggest that the use of laminar strut graft is as safe and cost-effective technique in single level PLIF especially in less developed regions.