A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion.
<h4>Background</h4>Transforaminal lumbar interbody fusion (TLIF) has become one of the most widely used procedures for lumbar spinal disorders. However, it is still unclear whether TLIF with unilateral pedicle screw (PS) fixation is as effective as that with bilateral PS fixation. We per...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2014-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0087501&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849254173552410624 |
|---|---|
| author | Xu-Qi Hu Xin-Lei Wu Cong Xu Xu-Hao Zheng Yong-Long Jin Li-Jun Wu Xiang-Yang Wang Hua-Zi Xu Nai-Feng Tian |
| author_facet | Xu-Qi Hu Xin-Lei Wu Cong Xu Xu-Hao Zheng Yong-Long Jin Li-Jun Wu Xiang-Yang Wang Hua-Zi Xu Nai-Feng Tian |
| author_sort | Xu-Qi Hu |
| collection | DOAJ |
| description | <h4>Background</h4>Transforaminal lumbar interbody fusion (TLIF) has become one of the most widely used procedures for lumbar spinal disorders. However, it is still unclear whether TLIF with unilateral pedicle screw (PS) fixation is as effective as that with bilateral PS fixation. We performed a meta-analysis of the literatures and aimed to gain a better understanding of whether TLIF with unilateral PS fixation was safe and effective for lumbar diseases.<h4>Methodology/principal findings</h4>We systematically searched Ovid, Springer, and Medline databases for relevant randomized controlled trials (RCTs) that compared the clinical and radiological outcomes of unilateral versus bilateral PS fixation in TLIF. Risk of bias in included studies was assessed using the Cochrane Risk of Bias tool. We generated pooled risk ratios or weighted mean differences across studies. According to our predefined inclusion criteria, seven RCTs with a total of 441 patients were included in this study. Baseline characteristics were similar between the unilateral and bilateral groups. Our meta-analysis showed that no significant difference was detected between the two groups in terms of postoperative clinical function, fusion status, reoperation rate, complication rate, and hospital stay (p>0.05). Pooled estimates revealed that the unilateral group was associated with significantly reduced implant cost, operative time and blood loss (p<0.05).<h4>Conclusions/significances</h4>Our meta-analysis suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation for lumbar diseases in selected patients. Despite these findings, our meta-analysis was based on studies with small sample size and different study characteristics that might lead to the inconsistent results such as various functional outcomes among the included studies. Therefore, high-quality randomized controlled trials with larger sample size are also needed to further clarify these issues and to provide the long-term outcomes. |
| format | Article |
| id | doaj-art-c7c51181b37a4d9bb8fe828ed30f17b1 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-c7c51181b37a4d9bb8fe828ed30f17b12025-08-20T03:56:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0191e8750110.1371/journal.pone.0087501A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion.Xu-Qi HuXin-Lei WuCong XuXu-Hao ZhengYong-Long JinLi-Jun WuXiang-Yang WangHua-Zi XuNai-Feng Tian<h4>Background</h4>Transforaminal lumbar interbody fusion (TLIF) has become one of the most widely used procedures for lumbar spinal disorders. However, it is still unclear whether TLIF with unilateral pedicle screw (PS) fixation is as effective as that with bilateral PS fixation. We performed a meta-analysis of the literatures and aimed to gain a better understanding of whether TLIF with unilateral PS fixation was safe and effective for lumbar diseases.<h4>Methodology/principal findings</h4>We systematically searched Ovid, Springer, and Medline databases for relevant randomized controlled trials (RCTs) that compared the clinical and radiological outcomes of unilateral versus bilateral PS fixation in TLIF. Risk of bias in included studies was assessed using the Cochrane Risk of Bias tool. We generated pooled risk ratios or weighted mean differences across studies. According to our predefined inclusion criteria, seven RCTs with a total of 441 patients were included in this study. Baseline characteristics were similar between the unilateral and bilateral groups. Our meta-analysis showed that no significant difference was detected between the two groups in terms of postoperative clinical function, fusion status, reoperation rate, complication rate, and hospital stay (p>0.05). Pooled estimates revealed that the unilateral group was associated with significantly reduced implant cost, operative time and blood loss (p<0.05).<h4>Conclusions/significances</h4>Our meta-analysis suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation for lumbar diseases in selected patients. Despite these findings, our meta-analysis was based on studies with small sample size and different study characteristics that might lead to the inconsistent results such as various functional outcomes among the included studies. Therefore, high-quality randomized controlled trials with larger sample size are also needed to further clarify these issues and to provide the long-term outcomes.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0087501&type=printable |
| spellingShingle | Xu-Qi Hu Xin-Lei Wu Cong Xu Xu-Hao Zheng Yong-Long Jin Li-Jun Wu Xiang-Yang Wang Hua-Zi Xu Nai-Feng Tian A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion. PLoS ONE |
| title | A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion. |
| title_full | A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion. |
| title_fullStr | A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion. |
| title_full_unstemmed | A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion. |
| title_short | A systematic review and meta-analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion. |
| title_sort | systematic review and meta analysis of unilateral versus bilateral pedicle screw fixation in transforaminal lumbar interbody fusion |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0087501&type=printable |
| work_keys_str_mv | AT xuqihu asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT xinleiwu asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT congxu asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT xuhaozheng asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT yonglongjin asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT lijunwu asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT xiangyangwang asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT huazixu asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT naifengtian asystematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT xuqihu systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT xinleiwu systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT congxu systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT xuhaozheng systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT yonglongjin systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT lijunwu systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT xiangyangwang systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT huazixu systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion AT naifengtian systematicreviewandmetaanalysisofunilateralversusbilateralpediclescrewfixationintransforaminallumbarinterbodyfusion |