Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion for the Treatment of Low Lumbar Degenerative Disc Diseases: Analysis of Clinical and Radiographic Results
Objective To compare the clinical and radiographic results of unilateral pedicle screw fixation (UPSF) and bilateral pedicle screw fixation (BPSF) after unilateral transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative disc diseases (DDDs). Methods A total of 63 patients who underwent UPSF or BPSF combined with unilateral TLIF at L4-L5 or L5-S1 in our hospital between 2014 and 2016 were included in this analysis. The perioperative outcomes and radiographic results were recorded at preoperative and postoperative follow-up. Fusion rates were determined according to the Bridwell–Lenke grading system. Clinical outcomes were evaluated using the visual analog scale, Oswestry Disability Index, and lumbar Japanese Orthopedic Association score. Results According to the perioperative assessment, the duration of operation, intraoperative and postoperative blood loss, duration of pain medication use, and hospital costs were significantly ( P P P Conclusions UPSF techniques with TLIF can attain similar clinical efficiency as BPSF techniques in treating single-level low lumbar DDD, but with fewer surgical injuries and at lower cost. BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. The long-term results require more study. Highlights UPSF has less trauma compared with BPSF. UPSF with TLIF can attain similar clinical efficiency as BPSF techniques at final postoperative follow-up. The clinical outcomes of UPSF were poorer than BPSF groups at 1 month postoperative. UPSF has a smaller impact on the cranial adjacent vertebral level compared with BPSF.
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