Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 12: pedicle screw fixation as an adjunct to posterolateral fusion for low-back pain

Standard. There is insufficient evidence to recommend a treatment standard. Guidelines. There is insufficient evidence to recommend a treatment guideline. Options. 1) Pedicle screw fixation is recommended as a treatment option for patients with low-back pain treated with PLF who are at high risk for fusion failure because the use of pedicle screw fixation improves fusion success rates. 2) Pedicle screw fixation as a routine adjunct to PLF in the treatment of patients with chronic low-back pain due to DDD is not recommended because there is conflicting evidence regarding a beneficial effect of pedicle screw fixation on functional outcome, and there is consistent evidence that the use of pedicle screw fixation is associated with higher costs and complications.