Unilateral versus bilateral pedicle screw instrumentation for single-level minimally invasive transforaminal lumbar interbody fusion |
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| Affiliation: | 1. Department of Orthopedics, Hôpitaux Iris Sud/IRIS South Teaching Hospitals, Brussels, Belgium;2. Department of Orthopaedic Surgery, Edith Cavell Clinic Hospital, Brussels, Belgium;3. Biomechanics Laboratory, Kinesiology Program, College of Health Solutions, Arizona State University, Phoenix, AZ, USA;4. Bone and Joint Research Center, Department of Orthopaedic Surgery, University of North Texas Health Science Center, Fort Worth, TX, USA;5. Department of Materials Science and Engineering, University of North Texas, Denton, TX, USA;6. Department of Movement Sciences, University of Idaho, Moscow, ID, USA;7. Department of Spinal Surgery, Royal Adelaide Hospital, Adelaide, Australia;8. Adelaide Centre for Spinal Research, SA Pathology, Adelaide, Australia;9. Centre for Orthopaedic and Trauma Research, University of Adelaide, Australia;10. Department of Orthopedics, St Pierre Hospital, Brussels, Belgium;1. Klinik für Orthopädie, Centrum für Muskuloskeletale Chirurgie, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;2. Department of Radiology, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany;3. Klinik für Orthopädie der Friedrich-Schiller-Universität Jena, Waldkrankenhaus “Rudolf Elle” gGmbH Eisenberg, Klosterlausnitzer Strasse 81, 06706 Eisenberg, Germany |
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| Abstract: | Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) has become an increasingly popular method of lumbar arthrodesis. However, there are few published studies comparing the clinical outcomes between unilateral and bilateral instrumented MIS TLIF. Sixty-five patients with degenerative lumbar spine disease were enrolled in this study. Thirty-one patients were randomized to the unilateral group and 34 to the bilateral group. Recorded demographic data included sex, age, preoperative diagnosis, and degenerated segment. Operative time, blood loss, hospital stay length, complication rates, and fusion rates were also evaluated. The Oswestry Disability Index (ODI) score and Visual Analog Scale (VAS) pain score data were obtained. All patients were asked to follow-up at 3 and 6 months after surgery, and once every 6 months thereafter. The mean follow-up was 26.6 months (range 18–36 months). The two groups were similar in sex, age, preoperative diagnosis, and operated level. The unilateral group had significantly shorter operative time, lower blood loss, and shorter hospital time than the bilateral group. The average postoperative ODI and VAS scores improved significantly in each group. No significant differences were found between the two groups in relation to ODI and VAS. All patients showed evidence of fusion at 12 months postoperatively. The total fusion rate, screw failure, and general complication rate were not significantly different. Results showed that single-level MIS TLIF with unilateral pedicle screw fixation would be sufficient in the management of preoperatively stable patients with lumbar degenerative disease. It seems that MIS TLIF with unilateral pedicle screw instrumentation is a better choice for single-level degenerative lumbar spine disease. |
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| Keywords: | Minimally invasive Spinal fusion TLIF Unilateral pedicle screw fixation |
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