Unilateral versus bilateral pedicle screw fixation in lumbar interbody fusion: a meta-analysis of complication and fusion rate.
Unilateral or bilateral pedicle screw (PS) fixation in lumbar interbody fusion remains controversial. The aim of this study was to evaluate the complication and fusion rate for both surgical techniques based on published studies. Pubmed, Cochrane Library and Embase Databases were searched to identify studies reporting complication rate or fusion rate of unilateral and bilateral PS fixation in lumbar interbody fusion. Outcomes of complication rate and fusion rate were analyzed. Seven articles including 501 patients were identified fitting inclusion criteria. There was no significant difference of total complication rate (RR 1.17, 95% CI: 0.73-1.89, P=0.51) and fusion rate (RR 0.94, 95% CI: 0.87-1.01, P=0.07) between the two groups. However, the fusion cage migration rate was significant higher (RR 2.41, 95% CI: 1.06-5.46, P=0.04) in unilateral group than bilateral group. In conclusion, the available evidence indicated that both unilateral PS fixation and bilateral PS fixation could get satisfactory fusion rate and complication rate. But unilateral PS fixation had more fusion cage migration than bilateral PS fixation in patients who undergo lumbar interbody fusion.
Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Address: NO. 301, Middle Yanchang Road, Shanghai, China; First Clinical Medical College, Nanjing Medical University, Nanjing, China, Address: NO. 301, Middle Yanchang Road, Shanghai, China. Electronic address: ycq890720@163.com.
Chaoqun
C
Yuan
Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Address: NO. 301, Middle Yanchang Road, Shanghai, China; First Clinical Medical College, Nanjing Medical University, Nanjing, China, Address: NO. 301, Middle Yanchang Road, Shanghai, China. Electronic address: magaer@126.com.
Kai
K
Chen
Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Address: NO. 301, Middle Yanchang Road, Shanghai, China.
Hailong
H
Zhang
First Clinical Medical College, Nanjing Medical University, Nanjing, China, Address: NO. 301, Middle Yanchang Road, Shanghai, China.
Hanyu
H
Zhang
Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Address: NO. 301, Middle Yanchang Road, Shanghai, China. Electronic address: ycq890722@163.com.
Shisheng
S
He
D001863:Bone Screws / Q000009:adverse effects; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
Cage migration; Complication; Fusion rate; Lumbar interbody fusion; Meta-analysis; Unilateral or bilateral fixation