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

Işik, Hasan Serdar; Okutan, Özerk; Yıldırım, Timur; Akpinar, Elif; Yılmaz, Ali

doi:10.5137/1019-5149.jtn.20531-17.1

Cited by 7 publications

(7 citation statements)

References 30 publications

(56 reference statements)

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“…[5] In the study of Shen et al (2016), they reported a mean preoperative VAS of 6.8±1.6, while in the study of Işik et al (2017) they reported a mean preoperative VAS of 8.57. [6,7] In the study of Dahdaleh et al (2013), they reported a mean preoperative VAS back of 5.7±2.6, while the mean preoperative leg visual analogue score (VAS) of the studied patients in was found to be 5.7±3.1; which were less than our patients scores. [8] Chen et al (2018) found in their study that the mean preoperative ODI score was 39.0±13.35, while Kai et al (2014) found in their study that the mean preoperative ODI score was 42.4±16%.…”

Section: Discussioncontrasting

confidence: 69%

Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)

Molla¹,

Anwer²,

Sabry³

2020

IJN

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Introduction: Lumbar degenerative diseases (LDD) is considered a common disease. Lumbar pedicular screw fixation and interbody fusion is one of the commonly used and effective surgical method in management of single-level lumbar degenerative diseases. Although bilateral pedicular screw (PS) fixation after lumbar interbody fusion is accepted as a standard surgical procedure providing rigid fixation with a great biomechanical stability and clinical benefits, the rigidity of bilateral (PS) fixation can cause device-related osteoporosis of the vertebrae which makes the adjacent segment prone to load and motion-induced degeneration. Therefore, the concept of using less rigid systems of fixation has been advocated. Aim of study: To evaluate effectiveness of unilateral pedicular screws fixation and interbody fusion in unilateral degenerative spine pathology. Patients and methods: This study included 34 patients with single level degenerative lumbar spine disease who were subjected to transforaminal interbody lumbar fusion (TILF) and unilateral transpedicular screws fixation between July 2017 and March 2019 in Ain Shams University hospitals. Results: The study was conducted on 34 patients with age ranging between 32-56 years (mean 45.12±7.80 years). There were 17 male and 17 female in this study. When comparing VAS back pain preoperatively and at postoperative intervals of 1,6 and 12 months, it showed highly significant improvement (P-value 0.000). Also when comparing VAS of leg pain preoperatively and at postoperative intervals of 1,6 and 12 months duration, it showed highly significant improvement (P-value 0.000). ODI preoperatively and at postoperative intervals of 1,6 and 12 months showed also highly significant improvement (P-value 0.000). Regarding the fusion rate, at 6 months postoperative 61.8% (21) of the patients had fusion grade 1,26.5% (9) of the patients had fusion grade 2 and 11.8% (4) of the patients had fusion grade 3. While at 12 months postoperative the percent of grade 1 fusion increased to become 85.3% (29 patients) and the rest were grade 2 fusions (14.7%) with no patients with grade 3 fusion. Conclusion: Unilateral pedicular screws and interbody fusion is a good modality of treatment for unilateral degenerative spine pathology.

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Section: Discussioncontrasting

confidence: 69%

Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)

Molla¹,

Anwer²,

Sabry³

2020

IJN

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“…In agreement with our results, Chen et al [3] found a highly statistically significant difference between preoperative and postoperative scores for both back pain and leg pain at the first, sixth, and twelfth postoperative month in both groups; and, on comparing the two groups, there was a statistically significant difference regarding VAS of the back pain in the first postoperative month, which was significantly lower in unilateral group; otherwise, there was no statistically significant difference regarding VAS of the back pain throughout the follow up period. Numerous authors reported similar results, including Işik et al [13], Yang et al [25], and Villavicencio et al [22].…”

Section: Clinical Outcomesmentioning

confidence: 57%

“…Concerning the radiological outcome, numerous authors reported similar results regarding the fusion rate at 6 and 12 months postoperatively without significant difference between the two group including Chen et al [3], Işik et al [13], Villavicencio et al [22], and Yang et al [25].…”

Section: Clinical Outcomesmentioning

confidence: 79%

“…On the other hand, Işik et al [13] observed a slight increase in VAS and ODI scores in both groups as their follow up got longer; they theorized that the natural process of degeneration develops by time and this increase may be induced by an adjacent segment degeneration that has developed or may develop in the future in all patients undergoing instrumented fusion. Within this framework, the need for longer follow-up is strongly considered.…”

Section: Clinical Outcomesmentioning

confidence: 97%

“…Our study described a mean operative time for patients of the unilateral group patients to be 122.44 ± 14.21 min, the longest operative time was 160 min, and the shortest was 115 min; while that in the bilateral group was 164.32 ± 14.22 min, the longest operative time was 190 min, and the shortest was 120 min. The mean operative time for the unilateral and the bilateral group according to Işik et al's [13] study was 111.7 ± 24.31 min and 158.6 ± 18.30 min respectively, a result close to ours; a lesser mean operative time was noted by Chen et al [3], being 89.8 ± 19.7 min in the unilateral group and 109.1 ± 15.3 min in the bilateral group, while Zhang et al [27] recorded a longer mean operative time of 208 (126-275) minutes and 257 (158-300) respectively.…”

Section: Clinical Outcomesmentioning

confidence: 99%

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Management of recurrent unilateral lumbar disc herniation in a single level: unilateral versus bilateral pedicle screws fixation with interbody fusion

Ahmed

Morad

Abdelbar

2020

Egypt J Neurol Psychiatry Neurosurg

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Background: Lumbar interbody fusion procedure is a recognized surgical technique in management of a variety of lumbar pathologies including recurrent lumbar disc prolapse. Interbody fusion augmented by pedicle screw fixation has been considered to improve fusion rates and clinical outcomes. Interbody fusion is commonly associated with better fusion potentials through applying the bone graft in the load bearing, vascular position of the anterior, and middle spinal columns. However, it still remains unknown whether interbody fusion with unilateral pedicle screw fixation (UPSF) is superior to that with bilateral pedicle screw fixation (BPSF). Aim of the work: The aim of this study is to evaluate the efficacy and safety of unilateral versus bilateral pedicle screw fixation associated with interbody fusion for the management of single level unilateral recurrent lumbar disc prolapse as regard the clinical and biomechanical results, operation time, intraoperative blood loss, and postoperative stay. Material and methods: This observational prospective comparative study of the two groups who were operated either unilateral (group A /15 patients) or bilateral (group B/15 patients) pedicle screw fixation with interbody fusion was done. Patients were followed up for 1, 6, ad 12 months. Results: Significant improvement in functional outcome of the two groups was noted compared to preoperatively, except in early postoperative period where the back VAS and ODI in the unilateral group was better than bilateral group. However, on further follow up, no significant difference was noticed. There was no significant difference comparing fusion rate, complication rate, and duration of hospital stay between the two groups at postoperative follow-up. There was significantly less blood loss, and significantly shorter operation time in the unilateral PS fixation group as compared with the bilateral PS fixation group in our study. Conclusion: Our study suggested that TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation for the management of recurrent single level lumbar disc prolapse; it showed better clinical outcome scores of ODI and back VAS, and a significant reduction of the intraoperative blood loss as well as the operation time, without significant differences considering fusion rate, complication rate, and duration of hospital stay between the two groups at postoperative follow-up. However, BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. Nevertheless, the long-term follow up is required to demonstrate the impact of these findings.

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Is unilateral pedicle screw fixation as effective as bilateral pedicle screw fixation in transforaminal lumbar interbody fusion: a meta-analysis of randomized controlled trials

Lin

et al. 2023

Eur Spine J

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

Abstract: 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.

Cited by 7 publications

References 30 publications

Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)

Unilateral Pedicular Screws and Interbody Lumbar Spine Fusion in Unilateral Degenerative Pathology (Technique and Outcome)

Management of recurrent unilateral lumbar disc herniation in a single level: unilateral versus bilateral pedicle screws fixation with interbody fusion

Is unilateral pedicle screw fixation as effective as bilateral pedicle screw fixation in transforaminal lumbar interbody fusion: a meta-analysis of randomized controlled trials

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