To investigate the incidence and risk factors of persistent low back pain (PLBP) after posterior decompression, bone grafting and fusion combined with internal fixation of lumbar spine for lumbar disc herniation. Methods: 123 patients with lumbar intervertebral disc herniation treated by posterior decompression, bone grafting and internal fixation from January 2015 to December 2017 were retrospectively analyzed. All patients with NRS greater than 50 at follow-up time points (3, 6 and 12 months after operation) were classified as PLBP group, included 11 cases, and the rest as non-PLBP group, included 112 cases. The characteristics (age, sex, BMI, NRS of low back pain, complications, smoking and drinking), operative variables (operation mode, operative segment, number of fusion segments, operation time, intraoperative blood loss, incision size), imaging parameters (preoperative LL, preoperative lumbar motion, correction of LL, Modic changes, preoperative FIR of paravertebral muscle) were recorded. Quantitative data were compared by independent sample t-test and qualitative data by Pearson chi-square test. Variables with P＜0.05 and some variables selected by experts were included in multivariate logistic regression analysis. Results: There were no differences in age, sex, BMI, complications, smoking, alcohol consumption, operation time, intraoperative blood loss, operation mode, number of fusion segments, incision size, preoperative LL, correction of LL, preoperative lumbar motion and Modic changes between the two groups. Preoperative low back pain in PLBP group was more serious than that in non-PLBP group, and L5-S1 operative segments were more common in PLBP group. The preoperative FIR of paravertebral muscles in PLBP group was higher than that in non-PLBP group. Multivariate logistic regression analysis showed preoperative low back pain (NRS > 28), operative segment L5-S1, and preoperative FIR > 14% of paravertebral muscles were independently correlated with PLBP. Conclusion: The incidence of PLBP after posterior decompression, bone grafting and internal fixation for lumbar disc herniation is 8.94%. The risk factors include preoperative low back pain, L5-S1 operative segment and preoperative paravertebral muscle degeneration.