Comparison of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion for single level lumbar degenerative diseases and review of literature

Abstract

AIM: To examine the clinical and radiological follow-ups and results of the patients undergoing fusion procedure by unilateral versus bilateral pedicle screw fixation (PSF) along with transforaminal lumbar interbody fusion (TLIF). MATERIAL and METHODS: Fifty-four patients were included in the study. Thirty-three patients were operated with bilateral PSF and TLIF and 21 had unilateral PSF and TLIF. The patients were evaluated preoperatively, on the postoperative 15th day, 6th and 12th months, and at the time of last examination (38 months in average for all patients) using Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). Fusion rates were examined with direct X-rays with flexion-extension dynamic views and 3D computed tomography (CT) scans. RESULTS: Operation times were shorter and blood loss was less in the unilateral PSF group. Fusion rates were similar in both groups with no statistical significance. For both groups, significant clinical improvement was observed based on the preoperative and postoperative scores. CONCLUSION: Unilateral PSF along with TLIF procedure is an effective option in selected patients. We need prospective randomized studies with higher number of patients and longer follow-up periods for more reliable results.