title: Unilateral versus bilateral pedicle screw fixation for degenerative lumbar diseases: a meta-analysis of 10 randomized controlled trials.
abstract: BACKGROUND
  The common and effective treatment for degenerative lumbar diseases is lumbar spinal fusion. Controversy still exists on the choice for instrumentation with spinal fusion procedures. Therefore, we conducted this meta-analysis exclusively of RCTs to compare the clinical outcomes of patients receiving bilateral versus unilateral pedicle screw fixation (PSF).
  
  
  METHODS
  After systematic review of published and unpublished literature, a meta-analysis was conducted to compare the 2 treatment strategies. The methodological quality of the literature was assessed using the PEDro critical appraisal tool.
  
  
  RESULTS
  Data synthesis showed less blood loss (P<0.001) and shorter operative time (P<0.001) in patients receiving unilateral PSF compared to bilateral PSF. However, there was no significant difference in fusion rates and functional outcomes between the 2 groups.
  
  
  CONCLUSIONS
  The meta-analysis indicated no significant difference in fusion rates and functional outcomes between the 2 treatment procedures, but unilateral PS fixation reduced blood loss and operative time.
authors.affiliation: Department of Spine Surgery, Jining No.1 People's Hospital, Shandong Academy of Medical Sciences, Jining, Shangdong, China (mainland).
authors.forename: Xianzhou
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Spine Surgery, Jining No.1 People's Hospital, Shandong Academy of Medical Sciences, Jining, Shangdong, China (mainland).
authors.forename: Chaoliang
authors.initials: C
authors.lastname: Lv
authors.affiliation: Department of Spine Surgery, Jining No.1 People's Hospital, Shandong Academy of Medical Sciences, Jining, Shangdong, China (mainland).
authors.forename: Tingzhen
authors.initials: T
authors.lastname: Yan
mesh_terms: D016063:Blood Loss, Surgical; D006760:Hospitalization; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D061646:Operative Time; D065289:Pedicle Screws / Q000009:adverse effects; D011182:Postoperative Care; D016032:Randomized Controlled Trials as Topic; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome