The Effiency Of Unilateral Versus Bilateral Pedicle Screw Fixation In Transforaminal Lumbar Interbody Fusion: A Systematic Review And Meta-Analysis

Objective:To compare the clinical outcome between unilateral and bilateral pedicle screw fixation in transforaminal lumbar interbody fusion(TLIF)for the treatment of lumbar degenerative diseases.Methods:The studies concerning unilateral or bilateral pedicle screw fixation in TLIF for the treatment of lumbar degenerative diseases from January 1982 to May 2016 were searched from Medline,Embase,Cochrane Central Register of Controlled Trails.And also searched from ACP Journal Club,Database of Abstracts of Review of Effectiveness for Unpublished literature or grey literature?The data of the studies were collected,risk of bias of the included RCTs were assessed according to Cochrane handbook 5.1.0,The nonunion rate?stability-related Complication rate?stability-related Complication reoperation rate data were Meta analyzed by Rev Man 5.2.0 software.Results:Twelve studies were included,containing 9 randomized controlled trials(RCT),1 Semi-randomized controlled study,there were 672 patients in total.The results showed that there was no significant difference between the two methods in nonunion rate and stability-related Complication reoperation rate.But there was significant difference in stability-related Complication rate and postoperation spinal scoliosis rate for unilateral than bilateral pedicle screw fixation in TLIF for lumbar degenerative diseases.Conclusion:There was no significant differcant difference in interbody nonunion rate and stability-related Complication reoperation rate for unilateral or bilateral pedicle screw fixation in TLIF for lumbar degenerative diseases.But there was significant difference in stability-related Complication rate and postoperation spinal scoliosis rate for unilateral than bilateral pedicle screw fixation in TLIF for lumbar degenerative diseases.