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18 March 2016 : Clinical Research  

Unilateral Pedicle Screw Fixation with Bone Graft vs. Bilateral Pedicle Screw Fixation with Bone Graft or Cage: A Comparative Study

Si-Dong YangACDE, Qian ChenABDE, Wen-Yuan DingAE, Jian-Qiang ZhaoBC, Ying-Ze ZhangDF, Yong ShenD, Da-Long YangACE

DOI: 10.12659/MSM.897639

Med Sci Monit 2016; 22:890-897


BACKGROUND: The aim of this study was to explore the clinical efficacy of unilateral pedicle screw fixation with bone graft (UPSFB) in treating single-segment lumbar degenerative diseases (LDD), as compared to bilateral pedicle screw fixation with bone graft (BPSFB) or with cage (BPSFC).

MATERIAL AND METHODS: Medical records were retrospectively collected between 01/2010 and 02/2015 in Longyao County Hospital. According to surgical methods used, all patients were divided into 3 groups: UPSFB group, BPSFB group, and BPSFC group. Clinical outcomes were evaluated by blood loss, blood transfusion, duration of operation, hospital stay, postoperative complications, interbody fusion rate, reoperation rate, medical expenses, patient satisfaction survey, and JOA score.

RESULTS: Ninety-five patients were included and underwent 2.5-year follow-up, with 7 patients lost to regular follow-up. As compared to the BPSFB group and BPSFC group, the UPSFB group had less blood loss and less blood transfusion, as well as shorter hospital stay (p<0.05). Medical expenses were far lower in the UPSFB group (p<0.001). There were no significant differences among the 3 groups in postoperative complications, interbody fusion rate, reoperation rate, JOA score, and patient satisfaction (all p>0.05).

CONCLUSIONS: As compared to BPSFB and BPSFC, UPSFB has the same reliability and effectiveness in treating single-segment LDD with unilateral radicular symptoms in a single lower extremity, with the additional advantage being less expensive.

Keywords: Blood Transfusion, Blood Loss, Surgical, Bone Transplantation, Length of Stay, Orthopedic Procedures - methods, Patient Satisfaction, Postoperative Complications - etiology, Reoperation, Spinal Fusion

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750