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Erschienen in:
01.02.2016 | Review Article
Unilateral versus bilateral pedicle screw fixation in short-segment lumbar spinal fusion: a meta-analysis of randomised controlled trials
Erschienen in: International Orthopaedics | Ausgabe 2/2016
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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.