title: A comparison of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for lumbar degenerative diseases.
abstract: BACKGROUND
  Bilateral transpedicular screw fixation in conjunction with interbody fusion is widely used to treat lumbar degenerative diseases; however, there are some disadvantages of using this fixation system. This study comparatively analyzes the results of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion (TLIF) for one-level lumbar degenerative diseases.
  
  
  METHODS
  Sixty-six cases with one-level lumbar degenerative diseases were studied. The patients were divided according to surgical approach into a unilateral group (Group A) and a bilateral group (Group B). The patients were evaluated for pain by visual analog scale (VAS) and Oswestry Disability Index (ODI). Operating time, blood loss, duration of hospitalization, and complication rate were also evaluated. Patients were examined at 1, 3, 6, and 12 months postoperatively and every year thereafter.
  
  
  RESULTS
  Group A patients' average preoperative VAS and ODI scores were 7.03 ± 0.98 and (64.22 ± 6.38)%, respectively, significantly decreased to 2.91 ± 0.88 and (14.42±2.08)%, respectively, at the last follow-up (P = 0.000). In Group B, the average preoperative VAS and ODI scores were 6.79 ± 0.86 and (63.22 ± 4.70)%, respectively, significantly decreased to 3.12 ± 0.96 and (14.62 ± 2.08)%, respectively, at the last follow-up (P = 0.000). No significant difference in the duration of hospitalization was found between groups. Operating time and blood loss of (125.9 ± 13.0) minutes and (211.4 ± 28.3) ml, respectively, in Group A were significantly less than (165.2 ± 15.3) minutes and (258.6 ± 18.3) ml, respectively, in Group B (P = 0.000). All patients achieved good bone union and had no pseudarthrosis at the last follow-up.
  
  
  CONCLUSIONS
  There are no clinical differences between unilateral and bilateral pedicle screw fixation combined with TLIF for one-level lumbar degenerative diseases. Unilateral fixation reduces operating time, bleeding, and cost of hospitalization.
authors.affiliation: Department of Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China.
authors.forename: Quanlai
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Department of Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China. Email: renmys2000@sina.com.
authors.forename: Hongguang
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Liu
authors.affiliation: Department of Preventive Medicine, Wannan Medical College, Wuhu, Anhui 241002, China.
authors.forename: Yuelong
authors.initials: Y
authors.lastname: Jin
mesh_terms: D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D065289:Pedicle Screws