A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion

Transforaminal lumbar interbody fusion (TLIF) has become one of the most widely used procedures for lumbar spinal disorders. However, it is still unclear whether TLIF with unilateral pedicle screw (PS) fixation is as effective as that with bilateral PS fixation. We performed a meta-analysis of the l...

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Bibliographic Details
Published in:PloS one 2014-01, Vol.9 (1), p.e87501-e87501
Main Authors: Hu, Xu-Qi, Wu, Xin-Lei, Xu, Cong, Zheng, Xu-Hao, Jin, Yong-Long, Wu, Li-Jun, Wang, Xiang-Yang, Xu, Hua-Zi, Tian, Nai-Feng
Format: Article
Language:English
Subjects:
Bias
Biology
Biomechanics
Blood Loss, Surgical
Bone implants
Bone Screws
Clinical outcomes
Clinical trials
Digitization
Disease
Fixation
Handbooks
Hospitals
Humans
Lumbar Vertebrae - surgery
Medical ethics
Medicine
Meta-analysis
Orthopedics
Patients
Randomization
Randomized Controlled Trials as Topic
Risk
Spinal Diseases - pathology
Spinal Diseases - surgery
Spinal Fusion - economics
Studies
Surgery
Systematic review
Treatment Outcome
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Summary:Transforaminal lumbar interbody fusion (TLIF) has become one of the most widely used procedures for lumbar spinal disorders. However, it is still unclear whether TLIF with unilateral pedicle screw (PS) fixation is as effective as that with bilateral PS fixation. We performed a meta-analysis of the literatures and aimed to gain a better understanding of whether TLIF with unilateral PS fixation was safe and effective for lumbar diseases. We systematically searched Ovid, Springer, and Medline databases for relevant randomized controlled trials (RCTs) that compared the clinical and radiological outcomes of unilateral versus bilateral PS fixation in TLIF. Risk of bias in included studies was assessed using the Cochrane Risk of Bias tool. We generated pooled risk ratios or weighted mean differences across studies. According to our predefined inclusion criteria, seven RCTs with a total of 441 patients were included in this study. Baseline characteristics were similar between the unilateral and bilateral groups. Our meta-analysis showed that no significant difference was detected between the two groups in terms of postoperative clinical function, fusion status, reoperation rate, complication rate, and hospital stay (p>0.05). Pooled estimates revealed that the unilateral group was associated with significantly reduced implant cost, operative time and blood loss (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0087501