Comparison of Unilateral versus Bilateral Pedicle Screw Fixation in Transforaminal Lumbar Interbody Fusion for Single Level Lumbar Degenerative Diseases and Review of Literature
Isik, Hasan Serdar and Okutan, Ozerk and Yildirim, Timur and Akpinar,
Elif and Yilmaz, Ali
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Abstract
AIM: To examine the clinical and radiological follow-ups and results of
the patients undergoing fusion procedure by unilateral versus bilateral
pedicle screw fixation (PSF) along with transforaminal lumbar interbody
fusion (TLIF).
MATERIAL and METHODS: Fifty-four patients were included in the study.
Thirty-three patients were operated with bilateral PSF and TLIF and 21
had unilateral PSF and TLIF. The patients were evaluated preoperatively,
on the postoperative 15th day, 6th and 12th montths, and at the time of
last examination (38 months in average for all patients) using Visual
Analogue Scale (VAS) and Oswestry Disability Index (ODI). Fusion rates
were examined with direct X-rays with flexion-extension dynamic views
and 3D computed tomography (CT) scans.
RESULTS: Operation times were shorter and blood loss was less in the
unilateral PSF group. Fusion rates were similar in both groups with no
statistical significance. For both groups, significant clinical
improvement was observed based on the preoperative and postoperative
scores.
CONCLUSION: 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
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