Unilateral veral pedicle screw fixation combined with transforaminal lumbar interbody fusion rsus bilatefor the treatment of low lumbar degenerative disc diseases:analysis of clinical and radiographic results.

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Unilateral veral pedicle screw fixation combined with transforaminal lumbar interbody fusion rsus bilatefor the treatment of low lumbar degenerative disc diseases:analysis of clinical and radiographic results.

World Neurosurg. 2018 Apr 24;:

Authors: Chen DJ, Yao C, Song Q, Tang B, Liu X, Zhang B, Dai M, Nie T, Wan Z

Abstract
OBJECTIVE: Our objective was to compare the clinical and radiographic results of unilateral pedicle screw fixation (UPSF) and bilateral pedicle screw fixation (BPSF) after unilateral transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative disc diseases (DDD).
MATERIALS AND METHODS: 63 patients who underwent UPSF or BPSF combined with unilateral TLIF at L4-L5 or L5-S1 were included in our hospital from 2014-2016. The perioperative outcomes and radiographic results were recorded at preoperative and postoperative follow-up. Fusion rates were determined according to the Bridwell-Lenke grading system. Clinical outcomes were evaluated by the VAS, the ODI and the lumbar JOA.
RESULTS: According to the perioperative assessments, the operation duration, intra- and postoperative blood loss, painkiller used time, and hospital costs of UPSF group were significantly (p<0.0001) less than the BPSF group. After mean 24 months follow-up, both UPSF and BPSF significantly (p<0.05) maintained the disk height and segmental lordosis of surgical segment and achieve similar clinical outcomes at final follow-up postoperative. The impacts of UPSF on the cranial adjacent vertebra level were significantly (p<0.05) smaller than the BPSF group in the short-term.
CONCLUSION: UPSF techniques with TLIF can attain similar clinical efficiency in treating of low lumbar DDD with single level, compared with BPSF techniques, but UPSF techniques with less surgical injuries and cost. BPSF with TLIF probably cause more degeneration at the cranial adjacent segment, when compared with UPSF techniques. The long term results still need to be observed.

PMID: 29702308 [PubMed - as supplied by publisher]

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