Unilateral versus bilateral pedicle screw fixation for degenerative lumbar diseases: a meta-analysis of 10 randomized controlled trials

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
Xianzhou LiTingzhen Yan

Abstract

The common and effective treatment for degenerative lumbar diseases is lumbar spinal fusion. Controversy still exists on the choice for instrumentation with spinal fusion procedures. Therefore, we conducted this meta-analysis exclusively of RCTs to compare the clinical outcomes of patients receiving bilateral versus unilateral pedicle screw fixation (PSF). After systematic review of published and unpublished literature, a meta-analysis was conducted to compare the 2 treatment strategies. The methodological quality of the literature was assessed using the PEDro critical appraisal tool. Data synthesis showed less blood loss (P<0.001) and shorter operative time (P<0.001) in patients receiving unilateral PSF compared to bilateral PSF. However, there was no significant difference in fusion rates and functional outcomes between the 2 groups. The meta-analysis indicated no significant difference in fusion rates and functional outcomes between the 2 treatment procedures, but unilateral PS fixation reduced blood loss and operative time.

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Citations

Apr 14, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kevin PhanRalph J Mobbs
Sep 2, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Yongqiang XuGang Wang

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