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Unilateral versus bilateral pedicle screw fixation for degenerative lumbar diseases: a meta-analysis of 10 randomized
Xianzhou Li1, Chaoliang Lv1, Tingzhen Yan1
1Department of Spine Surgery, Jining No.1 People's Hospital, Shandong Academy of Medical Sciences, Jining, Shangdong, China (mainland).
Background:
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).
Material And Methods:
After systematic review of published and unpublished literature, a meta-analysis was conducted to compare the 2 treatment strategies.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.
Results:
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.
Conclusions:
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.
