Unilateral versus bilateral pedicle screw fixation for degenerative lumbar diseases: A meta-analysis of 10 randomized controlled trials

Abstract

Background: The common and efective 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 me-ta-analysis exclusively of RCTs to compare the clinical outcomes of patients receiving bilateral versus unilateral pedicle screw fxation (PSF). Material/Methods: After systematic review of published and unpublished literature, a meta-analysis was conducted to compare the 2 treatment strategies.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 signifcant diference in fusion rates and functional outcomes between the 2 groups. Conclusions: The meta-analysis indicated no signifcant diference in fusion rates and functional outcomes between the 2 treatment procedures, but unilateral PS fxation reduced blood loss and operative time.