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International Orthopaedics
Published in: International Orthopaedics 2/2016

01-02-2016 | Review Article

Unilateral versus bilateral pedicle screw fixation in short-segment lumbar spinal fusion: a meta-analysis of randomised controlled trials

Authors: Zengfeng Xin, Weixu Li

Published in: International Orthopaedics | Issue 2/2016

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Abstract

Objective

We performed this meta-analysis of randomised controlled trials to compare the efficacy and safety of unilateral with bilateral fixation in short-segment lumbar spinal fusion.

Methods

Predefined terms were used to search electronic databases to identify relevant research. Randomised controlled trials (RCTs) published in English and Chinese during 1990–2015 investigating efficacy and safety of unilateral and bilateral fixation in short-segment lumbar spinal fusion were included. Data of fusion rate, complications, visual analogue scale (VAS), Oswestry Disability Index (ODI), estimated blood loss (EBL) and length of hospital stay were extracted and analysed. Two reviewers independently searched information sources, selected eligible research, analysed data and evaluated risk of bias.

Results

Eleven RCTs comprising 756 participants were analysed. There was no significant difference in fusion rate, device-related complication, ODI, VAS and length of hospital stay between bilateral and unilateral groups. The unilateral group had the obvious advantage of reduced blood loss [mean difference (MD) −143.57, 95 % confidence interval (Cl) -206.61 to -80.54, P < 0.0001) and operation time (MD -52.72, 95 % Cl -73.58 to -31.87, P < 0.00001).

Conclusion

Unilateral pedicle screw fixation is equally as effective as bilateral pedicle screw fixation in short-segment lumbar spinal fusion and may reduce operation time and blood loss.
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Metadata
Title
Unilateral versus bilateral pedicle screw fixation in short-segment lumbar spinal fusion: a meta-analysis of randomised controlled trials
Authors
Zengfeng Xin
Weixu Li
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 2/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-2842-3

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