Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13337-13348
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13337
Successful outcomes of unilateral vs bilateral pedicle screw fixation for lumbar interbody fusion: A meta-analysis with evidence grading
Lei Sun, Ai-Xian Tian, Jian-Xiong Ma, Xin-Long Ma
Lei Sun, Ai-Xian Tian, Jian-Xiong Ma, Xin-Long Ma, Orthopedic Research Institute, Tianjin Hospital, Tianjin University, Tianjin 300050, China
Author contributions: Sun L, Tian AX and Ma JX designed research, performed research, and wrote the paper; Ma XL was a major contributor in writing the manuscript and analyzed data, and all authors read and approved the final manuscript.
Supported by the Health Science and Technology of Tianjin Municipality, No. RC20204; Tianjin Institute of Orthopedics, No. 2019TJGYSKY03; and the National Natural Science Foundation of China, No. 818717771177226.
Conflict-of-interest statement: The authors declare no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Long Ma, MS, Professor, Orthopedic Research Institute, Tianjin Hospital, Tianjin University, No. 122 Munan Street, Heping District, Tianjin 300050, China. tianax1986@126.com
Received: August 19, 2022
Peer-review started: August 19, 2022
First decision: October 21, 2022
Revised: November 16, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
Processing time: 129 Days and 8.6 Hours
Core Tip

Core Tip: This literature is not strongly conclusive regarding whether bilateral pedicle screw (BPS) fixation or unilateral pedicle screw (UPS) one is more efficacious and safe for patients with lumbar degenerative diseases. While BPS has been considered standard, it has been associated with excessive rigidity and clinically adverse effects clinically, for example, device-related osteoporosis, adjacent segment degeneration, and a higher risk of other complications. This was the first large scale meta-analysis comparing UPS and BPS. We found UPS to have a slightly more poor fusion rate, but significantly improved prognosis regarding several clinical outcomes, possibly associated with minimal invasion.