Unilateral Pedicle Screw Fixation versus Bilateral Pedicle Screw Fixation for Single-Level Lumbar Degenerative Spine: A Systematic Review of Meta-analyses

A. Lychagin; V. Cherepanov; A. Garkavi; M. Lipina; I. Lisitzky; A. Korkunov; A. Zarov; A. Gritsyuk; M. Elizarov; G. Prah; Vyazankin Ivan

doi:10.3889/oamjms.2023.11649

Authors

A. Lychagin Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia; Laboratory of Clinical Smart Nanotechnologies, Sechenov First Moscow State Medical University, Moscow, Russia
V. Cherepanov Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
A. Garkavi Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia https://orcid.org/0009-0003-4707-1201
M. Lipina Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia; Laboratory of Clinical Smart Nanotechnologies, Sechenov First Moscow State Medical University, Moscow, Russia
I. Lisitzky Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
A. Korkunov Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
A. Zarov Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
A. Gritsyuk Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
M. Elizarov Department of Traumatology, Orthopedics and Disaster Surgery, Sechenov First Moscow State Medical University, Moscow, Russia https://orcid.org/0000-0002-4811-5718
G. Prah Ghana Health Service, Trauma and Specialist Hospital, Winneba, Ghana https://orcid.org/0009-0007-9643-299X
Vyazankin Ivan Department of Traumatology https://orcid.org/0000-0002-8020-2950

DOI:

https://doi.org/10.3889/oamjms.2023.11649

Keywords:

systematic review, lumbar spine, bilateral pedicle screw fixation, unilateral pedicle screw fixation

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.

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