A comparison of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for lumbar degenerative diseases

被引:3
作者
Yang Xiaoming [1 ]
Wang Hong [1 ]
Zhao Quanlai [1 ]
Xu Hongguang [1 ]
Liu Ping [1 ]
Jin Yuelong [2 ]
机构
[1] Yijishan Hosp, Dept Orthoped, Wannan Med Coll, Wuhu 241001, Anhui, Peoples R China
[2] Wannan Med Coll, Dept Prevent Med, Wuhu 241002, Anhui, Peoples R China
关键词
unilateral pedicle screw fixation; bilateral pedicle screw fixation; lumbar degenerative diseases; SPONDYLOLISTHESIS; STABILITY; SEGMENT; CAGES; SPINE;
D O I
10.3760/cma.j.issn.0366-6999.20141338
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Bilateral transpedicular screw fixation in conjunction with interbody fusion is widely used to treat lumbar degenerative diseases; however, there are some disadvantages of using this fixation system. This study comparatively analyzes the results of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion (TLIF) for one-level lumbar degenerative diseases. Methods Sixty-six cases with one-level lumbar degenerative diseases were studied. The patients were divided according to surgical approach into a unilateral group (Group A) and a bilateral group (Group B). The patients were evaluated for pain by visual analog scale (VAS) and Oswestry Disability Index (ODI). Operating time, blood loss, duration of hospitalization, and complication rate were also evaluated. Patients were examined at 1, 3, 6, and 12 months postoperatively and every year thereafter. Results Group A patients' average preoperative VAS and ODI scores were 7.03 +/- 0.98 and (64.22 +/- 6.38)%, respectively, significantly decreased to 2.91 +/- 0.88 and (14.42 +/- 2.08)%, respectively, at the last follow-up (P=0.000). In Group B, the average preoperative VAS and ODI scores were 6.79 +/- 0.86 and (63.22 +/- 4.70)%, respectively, significantly decreased to 3.12 +/- 0.96 and (14.62 +/- 2.08)%, respectively, at the last follow-up (P=0.000). No significant difference in the duration of hospitalization was found between groups. Operating time and blood loss of (125.9 +/- 13.0) minutes and (211.4 +/- 28.3) ml, respectively, in Group A were significantly less than (165.2 +/- 15.3) minutes and (258.6 +/- 18.3) ml, respectively, in Group B (P=0.000). All patients achieved good bone union and had no pseudarthrosis at the last follow-up. Conclusions There are no clinical differences between unilateral and bilateral pedicle screw fixation combined with TLIF for one-level lumbar degenerative diseases. Unilateral fixation reduces operating time, bleeding, and cost of hospitalization.
引用
收藏
页码:3592 / 3596
页数:5
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