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| WANG Chong,FANG Mingqiao,XIANG Guangheng.Comparison of the long-term outcomes of unilateral versus bilateral pedicle screw fixation with transforaminal lumbar interbody fusion in degenerative lumbar diseases[J].Chinese Journal of Spine and Spinal Cord,2014,(9):795-801. |
| Comparison of the long-term outcomes of unilateral versus bilateral pedicle screw fixation with transforaminal lumbar interbody fusion in degenerative lumbar diseases |
| Received:July 08, 2014 Revised:August 21, 2014 |
| English Keywords:Interbody fusion Unilateral Bilateral Fixation Lumbar degenerative diseases |
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| English Abstract: |
| 【Abstract】 Objectives: To compare the long-term outcomes of unilateral versus bilateral pedicle screw fixation(PS) with transforaminal lumbar interbody fusion(TLIF) in degenerative lumbar diseases. Methods: From March 2005 to October 2009, 80 patients with the degenerative disorders of lumbar spine were treated by unilateral versus bilateral pedicle screw fixation(PS) with TLIF, 38 patients(21 males and 17 females; range, 34-68 years, average age 52.4 years) were randomized to the unilateral PS group and 42 patients(23 males and 19 females; range, 32-75 years, average age 53.7 years) to the bilateral PS group. Postsurgical pain and functional results were analyzed by the visual analog scale(VAS) and Oswestry disability index(ODI). Radiological examination was obtained for each patient to assess the height of intervertebral space, postoperative intervertebral fusion conditions and general complications． Results: The mean follow-up was 6.8 years, with a range of 5 to 8 years. The most frequently used methods to assess the clinical function were visual analog VAS scores and ODI scores, the pooled data did not reveal any significant difference between the two groups(P>0.05), but statistically significant differences were noted between the preoperative and final follow-up ones(P<0.05). No statistical difference in disc height was noted between preoperation and final follow-up for each group(P>0.05), but the postoperative radiologic indexes of all patients were higher than the preoperative ones(P<0.05)． The fusion rate showed no significant difference between two groups(P>0.05). Pooled estimates revealed that the unilateral group was associated with significantly less incidence of the adjacent segment disease and paraspinal muscle fibrosis(P<0.05). There were no complications such as secondary scoliosis, loss of disc height, cage slippage, screw loosening and internal fixation failure. Conclusions: Lumbar interbody fusion with unilateral pedicle screw fixation is as effective as bilateral pedicle screw fixation. |
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