Clinical Analysis Of The Efficiency Of Unilateral And Bilateral Fixation For Lumbar Interbody Fusion For Degenerative Diseases

ObjectiveCurrent clinical lumbar disc herniation or spondylolisthesis on the surgical treatmentof common surgical procedures are a laminectomy and discectomy with bilateral pediclescrew fixation.This surgical method can provide enough stiffness and sustains the stabilityof the spine.But the method changes spine’s biomechanical characteristics to a largeextent,and spends much higher.Thus controversial of this method exists a long time amongsurgeons.So how to strictly restrict the inclusion criterion,reduce the removal of the scopeof the fixed segment and the degeneration of the adjacent levels has attached greatimportance to the sergeons.This study gives a new way,that is unilateral pedical screwfixation(UPSF) to compare clinical and radiographic results in the patients selected to treatwith bilateral pedical screw fixation(BPSF).MethodIn this research we choose120patients in all.57patients (27men and30women;average age56.2years) were randomized enrolled into the unilateral PS group and63patients (28men and35women; average age57.3years) into the bilateral pedical screwfixation group.The basic information we collected includes age,gender,preoperativediagnosis, degenerated segment, and single/double level of fusion. We also estimatedoperating time, loss of blood, length of stay and implant costs. Visual analog scale (VAS)and Oswestry Disability Index (ODI)were used to analyze postoperative pain andfunctional outcomes. Radiographic examinations were carried out to assess total fusionrates, screw failure, and general complications. We asked the patients to return to hospitalat3months,6months,12months for follow-up, and then once a year after the surgery.ResultsThe average time for follow-up is20.2months, with a range of18to24months. Therewere no significant differences between the UPSF and BPSF in terms of demographic data. In the UPSF group, the operative time was significantly shorter,blood loss was much lessand implant costs was lower compared with the BPSF group.The average postoperativeVAS and ODI scores of the two groups improved significantly.There were no significantdifference in the fusion rate, screw failure, and complication rate.ConclutionUPSF is a good suegical treatment with better results, especially in the operative time,blood loss, implant costs and length of stay for single-level,the advantage was obvious. Inthis group, the decrease of the fusion rate and raise in the complication rate were notobserved.Although several advantages were observed,further improved study design,much more patients and a longer period of follow-up are needed to confirm this effect.