Posterior longitudinal ligament suturation after lumbar discectomy provides postoperative a large intradural area: First report

BACKGROUND: Stability and flexibility of the spine are provided by the posterior longitudinal ligament (PLL). It plays a key role in the pathogenesis of lumbar disc herniation (LDH) by preventing disc protrusion. The effect of the suturing of the PLL on the intradural area was investigated. PATIENTS AND METHODS: The patients were included in whom lumbar microdiscectomy was performed between January 2021 and July 1, 2022. The patients were randomly divided into two groups as PLLs were sutured and unsutured. RESULTS: Forty-six (23 males and 23 females) patients were included. The PLLs were sutured in 22 patients (Group 1) and not sutured in 24 patients (Group 2). The levels, sides of LDHs, and ages and gender of patients were also analyzed in both groups, which were not statistically significant. Preoperative mean spinal intradural areas were 77.29 mm(2) for the PLL unsutured group and 85.40 mm(2) for the PLL sutured group (Groups 1 and 2). For patients in Groups 1 and 2, the postoperative mean spinal intradural areas grew to 134.73 mm(2) and 96.12 mm(2), respectively. The difference in preoperative mean spinal intradural regions between the two groups was not statistically significant; however, Group 1 showed a substantial difference (sutured PLL patients). CONCLUSIONS: This study first time indicates that suturing PLL has a protective and supportive role in patients who were operated on for LDH.