Abstract
AIM: The objectives of this study were to perform a systematic literature review based on studies that compare unilateral and bilateral pedicle screw fixation (PSF) in lumbosacral spine fusion to provide recommendations for the treatment of degenerative diseases of the spine, to identify studies with a more complete evidence base, and to identify possible limitations in available literature sources that require further research.
METHODS: A literature search was conducted in PubMed, Embase, and the Cochrane Library to identify studies that compare unilateral versus bilateral PSF versus interbody implant placement used the treatment of degenerative diseases of the lumbosacral spine. The study included meta-analyses that met the inclusion criteria. The quality of meta-analyses was evaluated with a measurement tool to assess systematic reviews (AMSTAR) score and the most relevant meta-analysis was determined by applying the Jadad algorithm.
RESULTS: Twelve studies fulfilled the eligibility criteria and were included in the study. The results of AMSTAR score ranged from 6 to 9, based on the results, four meta-analysis can be assigned to “middle” category and remained 8 to “upper” category. According to the results obtained, there was no significant difference between unilateral and bilateral PSF; however, unilateral fixation had advantages in the duration of surgical treatment and intraoperative blood loss.
СONCLUSION: According to this systematic review, unilateral PSF is an effective fixation method in the formation of lumbosacral spine fusion and has advantages in reducing the duration of surgical treatment and intraoperative blood loss compared to bilateral PSF.
Publisher
Scientific Foundation SPIROSKI
Reference46 articles.
1. Moura DL, Lawrence D, Gabriel JP. Multilevel anterior lumbar interbody fusion combined with posterior stabilization in lumbar disc disease-prospective analysis of clinical and functional outcomes. Rev Bras Ortop (Sao Paulo). 2019;54(2):140-8. https://doi.org/10.1016/j.rbo.2017.11.006 PMid:31363259
2. Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: Techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ ATP, LLIF and ALIF. J Spine Surg. 2015;1(1):2-18. https://doi.org/10.3978/j.issn.2414-469X.2015.10.05 PMid:27683674
3. Schizas C, Michel J, Kosmopoulos V, Theumann N. Computer tomography assessment of pedicle screw insertion in percutaneous posterior transpedicular stabilization. Eur Spine J. 2007;16(5):613-7. https://doi.org/10.1007/s00586-006-0221-x PMid:16967297
4. Metzger MF, Robinson ST, Svet MT, Liu JC, Acosta FL. Biomechanical analysis of the proximal adjacent segment after multilevel instrumentation of the thoracic spine: Do hooks ease the transition? Global Spine J. 2016;6(4):335-43. https://doi.org/10.1055/s-0035-1563611 PMid:27190735
5. Lee CS, Hwang CJ, Lee SW, Ahn YJ, Kim YT, Lee DH, et al. Risk factors for adjacent segment disease after lumbar fusion. Eur Spine J. 2009;18(11):1637-43. https://doi.org/10.1007/s00586-009-1060-3 PMid:19533182