Unilateral versus bilateral pedicle screw fixation for treating two-level lumbar degenerative diseases

Abstract

Abstract This study aimed to compare the clinical efficacy and radiological results between unilateral pedicle screw fixation (UPSF) and bilateral pedicle screw fixation (BPSF) for treating two-level lumbar degenerative diseases. The study involved 106 patients with two-level lumbar degenerative diseases. In the UPSF group ( n  = 52), 28 underwent intervertebral fusion (IF), 17 underwent posterolateral fusion (PLF), and 7 underwent IF & PLF. In the BPSF group ( n  = 54), 43 underwent IF, 2 underwent PLF, and 9 underwent IF & PLF. The clinical efficacy and radiological data were evaluated and compared. The UPSF group was significantly lower than the BPSF group regarding operation time, intraoperative blood loss, and hospitalization expenses. Postoperative visual analog scale scores and oswestry disability index were significantly decreased in both groups compared with pre-surgery. At the last follow-up, the intervertebral disc height of the cranial adjacent segment decreased more in the UPSF group compared with the BPSF group. The incidence of screw loosening in the UPSF group was significantly higher compared with the BPSF group. Compared to BPSF, UPSF can achieve similar and satisfactory clinical efficacy for the treatment of two-level lumbar degenerative diseases with less operation time, muscle damage, blood loss, and hospitalization expenses. However, the occurrence of pedicle screw loosening was higher in the UPSF group.