title: The combined use of unilateral pedicle screw and contralateral facet joint screw fixation in transforaminal lumbar interbody fusion.
abstract: OBJECTIVE
  This paper is to evaluate the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws along with contralateral translaminar facet joint screw (UPS+TFS) fixation in comparison with the method using bilateral pedicle screws fixation (BPS) in degenerative lumbar diseases.
  
  
  METHODS
  Forty patients with single-level lumbar diseases were divided into two groups randomly. One group was treated by TLIF with BPS fixation while the other group was treated by the new technique with UPS+TFS fixation. The preoperative and postoperative ODI, JOA, VAPS scores, mean operation time, mean operation blood loss, fusion rate and complications were collected for comparison under two surgical methods. In terms of complications, only two cases of superficial infection in the BPS group and one case of urinary tract infection in the other group was found.
  
  
  RESULTS
  The mean operation time and blood loss was significantly less in UPS+TFS group than in BPS group. The preoperation and postoperative ODI, JOA and VAPS at the intervals of 6 weeks, 3, 6 months and 1 year between the BPS and UPS+TFS group showed no significant disparities. Only one patient in UPS+TFS group was not fused with pseudoarthrosis formation.
  
  
  CONCLUSIONS
  The clinical efficacy and safety of TLIF with UPS+TFS fixation were comparable to BPS fixation; however, the soft tissue injury and the corresponding operation cost were reduced with unilateral pedicle screw plus translaminar facet screw fixation.
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital, Fudan University, 180 Fenglin road, Xuhui district, Shanghai, China.
authors.forename: Yuanwu
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital, Fudan University, 180 Fenglin road, Xuhui district, Shanghai, China.
authors.forename: Zixian
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital, Fudan University, 180 Fenglin road, Xuhui district, Shanghai, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital, Fudan University, 180 Fenglin road, Xuhui district, Shanghai, China.
authors.forename: Shengcheng
authors.initials: S
authors.lastname: Wan
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital, Fudan University, 180 Fenglin road, Xuhui district, Shanghai, China. c13817264291@sina.com.cn.
authors.forename: Xiaoxing
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Orthopaedics, Zhongshan Hospital, Fudan University, 180 Fenglin road, Xuhui district, Shanghai, China. minimalcountry@sina.com.cn.
authors.forename: Zhenzhou
authors.initials: Z
authors.lastname: Feng
mesh_terms: D001863:Bone Screws; D003365:Costs and Cost Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D061646:Operative Time; D065289:Pedicle Screws; D011184:Postoperative Period; D017695:Soft Tissue Injuries / Q000209:etiology; D013123:Spinal Fusion / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Bilateral pedicle screw; Lumbar degenerative disease; Transforaminal lumbar interbody fusion; Translaminar facet joint screw; Unilateral pedicle screw