title: Unilateral Pedicle Screw Fixation with Bone Graft vs. Bilateral Pedicle Screw Fixation with Bone Graft or Cage: A Comparative Study.
abstract: BACKGROUND
  The aim of this study was to explore the clinical efficacy of unilateral pedicle screw fixation with bone graft (UPSFB) in treating single-segment lumbar degenerative diseases (LDD), as compared to bilateral pedicle screw fixation with bone graft (BPSFB) or with cage (BPSFC).
  
  
  METHODS
  Medical records were retrospectively collected between 01/2010 and 02/2015 in Longyao County Hospital. According to surgical methods used, all patients were divided into 3 groups: UPSFB group, BPSFB group, and BPSFC group. Clinical outcomes were evaluated by blood loss, blood transfusion, duration of operation, hospital stay, postoperative complications, interbody fusion rate, reoperation rate, medical expenses, patient satisfaction survey, and JOA score.
  
  
  RESULTS
  Ninety-five patients were included and underwent 2.5-year follow-up, with 7 patients lost to regular follow-up. As compared to the BPSFB group and BPSFC group, the UPSFB group had less blood loss and less blood transfusion, as well as shorter hospital stay (p<0.05). Medical expenses were far lower in the UPSFB group (p<0.001). There were no significant differences among the 3 groups in postoperative complications, interbody fusion rate, reoperation rate, JOA score, and patient satisfaction (all p>0.05).
  
  
  CONCLUSIONS
  As compared to BPSFB and BPSFC, UPSFB has the same reliability and effectiveness in treating single-segment LDD with unilateral radicular symptoms in a single lower extremity, with the additional advantage being less expensive.
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Si-Dong
authors.initials: SD
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China (mainland).
authors.forename: Qian
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Ding
authors.affiliation: Department of Orthopedic Surgery, Longyao County Hospital, Longyao, Hebei, China (mainland).
authors.forename: Jian-Qiang
authors.initials: JQ
authors.lastname: Zhao
authors.affiliation: , Hebei Provincial Key Laboratory of Orthopaedic Biomechanics, Shijiazhuang, Hebei, China (mainland).
authors.forename: Ying-Ze
authors.initials: YZ
authors.lastname: Zhang
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Yong
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland).
authors.forename: Da-Long
authors.initials: DL
authors.lastname: Yang
mesh_terms: D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D016025:Bone Transplantation; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction; D065289:Pedicle Screws; D011183:Postoperative Complications / Q000209:etiology; D012086:Reoperation; D013123:Spinal Fusion