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Archives of Orthopaedic and Trauma Surgery

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01-04-2017 | Orthopaedic Surgery

Effectiveness and safety of unilateral pedicle screw fixation in transforaminal lumbar interbody fusion (TLIF): a systematic review and meta-analysis

Authors: Chunpeng Ren, Rujie Qin, Penghao Sun, Peng Wang

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2017

Abstract

Purpose

To evaluate the effectiveness and safety of unilateral pedicle screw fixation in transforaminal lumbar interbody fusion (TLIF) by comparing with bilateral pedicle screw fixation.

Materials and methods

PubMed, EMBASE, and the Cochrane Central Register of Controlled Trial database were used to search and identify clinical prospective trials that evaluated the efficacy and safety of unilateral fixation as compared with bilateral fixation in TLIF surgery. The methodological qualities of studies were assessed using the PEDro (Physiotherapy Evidence Database) score and Newcastle–Ottawa Scale.

Results

Fourteen prospective studies comprising 954 participants were analyzed. Data synthesis show lower fusion rate (P = 0.03) and more cage migration (P = 0.04) in unilateral group compared to bilateral group. There was no significant difference in visual analog scale (VAS), Oswestry Disability Index (ODI), the Short Form 36 Health Survey (SF-36) physical component score (PCS), and length of hospital stay between unilateral and bilateral groups. The unilateral group had shorter operative time (P < 0.00001) and less blood loss (P = 0.0007).

Conclusions

Based on this systematic review and meta-analysis, the unilateral fixation in TLIF may achieve a similar clinical outcome and reduce blood loss and operative time when compared with that in bilateral fixation. However, the unilateral fixation may produce lower fusion rate and more cage migration than bilateral fixation in TLIF

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Title: Effectiveness and safety of unilateral pedicle screw fixation in transforaminal lumbar interbody fusion (TLIF): a systematic review and meta-analysis
Authors: Chunpeng Ren
Rujie Qin
Penghao Sun
Peng Wang
Publication date: 01-04-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2641-y

At a glance: The STEP trials

Springer Medicine

Effectiveness and safety of unilateral pedicle screw fixation in transforaminal lumbar interbody fusion (TLIF): a systematic review and meta-analysis

Abstract

Purpose

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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