Sun L, Tian AX, Ma JX, Ma XL. Successful outcomes of unilateral vs bilateral pedicle screw fixation for lumbar interbody fusion: A meta-analysis with evidence grading. World J Clin Cases 2022; 10(36): 13337-13348 [PMID: 36683615 DOI: 10.12998/wjcc.v10.i36.13337]
Corresponding Author of This Article
Xin-Long Ma, MS, Professor, Orthopedic Research Institute, Tianjin Hospital, Tianjin University, No. 122 Munan Street, Heping District, Tianjin 300050, China. tianax1986@126.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 26, 2022; 10(36): 13337-13348 Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13337
Successful outcomes of unilateral vs bilateral pedicle screw fixation for lumbar interbody fusion: A meta-analysis with evidence grading
Lei Sun, Ai-Xian Tian, Jian-Xiong Ma, Xin-Long Ma
Lei Sun, Ai-Xian Tian, Jian-Xiong Ma, Xin-Long Ma, Orthopedic Research Institute, Tianjin Hospital, Tianjin University, Tianjin 300050, China
Author contributions: Sun L, Tian AX and Ma JX designed research, performed research, and wrote the paper; Ma XL was a major contributor in writing the manuscript and analyzed data, and all authors read and approved the final manuscript.
Supported bythe Health Science and Technology of Tianjin Municipality, No. RC20204; Tianjin Institute of Orthopedics, No. 2019TJGYSKY03; and the National Natural Science Foundation of China, No. 818717771177226.
Conflict-of-interest statement: The authors declare no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Long Ma, MS, Professor, Orthopedic Research Institute, Tianjin Hospital, Tianjin University, No. 122 Munan Street, Heping District, Tianjin 300050, China. tianax1986@126.com
Received: August 19, 2022 Peer-review started: August 19, 2022 First decision: October 21, 2022 Revised: November 16, 2022 Accepted: December 5, 2022 Article in press: December 5, 2022 Published online: December 26, 2022
ARTICLE HIGHLIGHTS
Research background
The use of unilateral pedicle screw (UPS) or bilateral pedicle screw (BPS) fixation for lumbar degenerative diseases remains controversial.
Research motivation
To provide objective evidence for the selection of UPS or BPS fixation for lumbar degenerative diseases.
Research objectives
To compare the efficacy and safety of UPS and BPS fixation in patients with lumbar degenerative diseases.
Research methods
We used meta-analysis to systematically review the current evidence.
Research results
UPS had slightly lower effects on fusion rate, which was the main contribution of this meta-analysis, and similar complication rates, Δ visual analog scale, and Δ Oswestry disability index. In contrast, there was a significant difference in Δ Japanese Orthopedic Association (JOA) score, total blood loss, operation time, and length of hospital stay.
Research conclusions
Unilateral fixation is less effective than bilateral fixation regarding fusion rate after lumbar interbody fusion. However, JOA, total blood loss, operation time, and length of stay were improved for unilateral fixation.
Research perspectives
To clarify whether UPS has the same reliability and effectiveness as BPS, longer follow-up and more clinical trials, especially RCTs, are required to provide stronger evidence regarding this observation. Further multicenter studies with more patients are required to obtain more reliable results.
