Comparison of unilateral versus bilateral pedicle screw fixation in degenerative lumbar diseases: a meta-analysis
| Autor: | Li-Jun Li, Jun Tan, Ying-Chao Han, Shan-Jin Wang, Zhuqing Liu |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Lumbar Vertebrae Databases Factual business.industry Odds ratio Intervertebral Disc Degeneration Length of Stay Severity of Illness Index Surgery Lumbar Postoperative Complications Treatment Outcome Blood loss Pedicle Screws Meta-analysis Severity of illness medicine Humans Orthopedics and Sports Medicine Neurosurgery Pedicle screw fixation business Fixation (histology) |
| Zdroj: | European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 23(5) |
| ISSN: | 1432-0932 |
| Popis: | Traditionally, lumbar spinal surgery is performed with bilateral pedicle screw fixation to provide stability as the fusion heals. However, many studies have reported that unilateral pedicle screw fixation is as effective as bilateral constructs. To compare the clinical outcomes, complications, and surgical trauma between the two techniques for treatment of degenerative lumbar diseases, we conducted a meta-analysis. We searched MEDLINE, EMBASE, PubMed, Google Scholar, and Cochrane databases for relevant controlled studies up to August 2013 that compared unilateral with bilateral fixation for the treatment of degenerative lumbar diseases. We independently performed title/abstract screening and full-text screening. A random effects model was used for heterogeneous data; otherwise, a fixed effect model was used, pooling data using mean difference (MD) for continuous outcomes and odds ratio (OR) for dichotomous outcomes. A total of 12 articles (865 participants) were eligible. Overall, there were significant differences between the two groups for blood loss (MD = −171.73, 95 % CI = −281.70 to −61.76; p = 0.002), operation time (MD = −66.02, 95 % CI = −115.52 to −16.51; p = 0.009), and fusion rate (OR = 0.50, 95 % CI = 0.26–0.96; p = 0.004). However, there were no significant differences in hospital stay (MD = −4.44, 95 % CI = −13.37 to 4.50), ODI (MD = −0.09, 95 % CI = −0.59 to 0.42; p = 0.74), JOA (MD = 0.18, 95 % CI = −0.77 to 1.14; p = 0.71), VAS (MD = −0.04, 95 % CI = −0.16 to 0.08; p = 0.49), SF-36 (PF: MD = −1.11, 95 % CI = −4.38 to 2.17, p = 0.51; GH: MD = 1.22, 95 % CI = −2.17 to 4.60, p = 0.48; MH: MD = −0.22, 95 % CI = −3.83 to 3.38, p = 0.90) and complications (OR = 1.15, 95 % CI = 0.72–1.85; p = 0.56). This meta-analysis shows that there was significantly less blood loss in unilateral group and less operating time; however, the fusion rate was significantly higher in the bilateral group. The outcomes of hospital stay, ODI, JOA, VAS, SF-36 score, and complications are similar in the two groups. |
| Databáze: | OpenAIRE |
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