The Efficacy Of Unilateral Pedicle Screws And Bilateral Pedicle Screws In Lumbar Fusion Surgery

Purpose: To compare the clinical effects of bilateral decompression through unilateral laminectomy by paramedian incision using unilateral pedicle screw instrumentation and bilateral laminectomy for decompression by bilateral paramedian incision using bilateral pedicle screw instrumentation in transforaminal posterior lumbar interbody fusion(TLIF).Methods: From 5/15/2007 to 12/15/2007, 20 patients had underwent TLIF surgery, we arranged the patients to unilateral group (Group A) or bilateral group (Group B) by randomize. Among Group A, there are 3 males and 5 females, 5 in L45 and 3 in L5S1. Their mean age is 51. 75 years old. Among Group B, there are 6 males and 6 females, 11 in L45 and 1 in L5S1. Their mean age is 51. 92 years old. We compare the clinical effects between Group A and Group B by using Oswestry Disability Index, JOA Index and VAPS Index. We also compare the operating time, blood loss and fusion rates between them.Results: The follow-up time is 3 months to 6 months. The ODI, JOA and VAPS indexes of the patients showed significant differences between preoperative and 3 months after operative among Group A and Group B(p<0.05). The ODI, JOA and VAPS indexes of the patient which collected at 6 weeks, 3 months 6 months showed no significant differences between Group A and Group B (p>0.05) . The operating time of Group A is shorter than Group B, which showed significant differences. (p<0.05) The blood loss showed no significant differences between Group A and Group B. The post operation fusion rates at 3 months of both groups is 100%. There are no postoperative complications of both groups.Conclusions: Both of the bilateral decompression through unilateral laminectomy by paramedian incision using unilateral pedicle screw instrumentation and bilateral laminectomy for decompression by bilateral paramedian incision using bilateral pedicle screw instrumentation had significant effects in transforaminal posterior lumbar interbody fusion. There are no significant differences between them.