Comparison between Unilateral and Bilateral Pedicle Screw Fixation in Lumbar Spinal Fusion
Keywords:
unilateral, bilateral, pedicle screw fixationAbstract
Objectives : To determine and comparison unilateral pedicle screw fixation with bilateral fixation in one or two segment lumbar spinal fusion
Background : clinical results for unilateral variable screw fixation in isolated L4-5 fusion have been reported to be as good as those for bilateral pedicle screw fixation However, unilateral fixation may not be recommended for multilevel fusion.
Methods : Prospective study of 87 patients in Roi-Et hospital were assigned to either unilateral (n = 47 ) or bilateral (n = 40) pedicle screw fixation groups. Operating time, fusion rates and complication rates, were Studies and tested with Independent sample t test X2 test and Fishers exact test
Results : There were no significant differences between the two groups in blood loss, clinically satisfactory results , fusion rate and complication rate. But significant differences in duration of operating time, and duration of hospital stay. The number of fusion segments did not affect the fusion rate or Clinical outcomes
Conclusion : Unilateral pedicle screw fixation was effective as bilateral pedicle screw fixation in lumbar spinal fusion segments (one or two segments) Based on the results of this study. Unilateral fixation could be used in two segment lumbar spinal fusion.
References
Lee CK,Langrana NA,Lumbossacral spinal fusion : A biomechanical study spine 1984 ; 574 – 81
Nagata H,Lewis JL,Schendel MJ. The effect of immobilization of long segments of the spine on the adjacent and distal facet force and lumbosacral motion spine 1993; 18 : 2471 – 9
Kabins MB, Weinstein JN. Isolated L4 – 5 fusion using the variable screw Placement system : Unilateral versus bilateral . J spinal Disord 1992 ; 5 : 39 – 49
Kim NH,Kim DJ. Anterior Interbody fusion for spondylolisthesis.Orthepaedics 1991;14:1069 – 26
Krag MH,Pope MH,Frymoyer JW,Weaver DL. An internal fixation for Posterior application to short segment of the thoracic , lumbar or lumbosacral spine.Clin Orthop 1986; 203 : 75 – 98
Roy – Camille R,Saillant G, Mazol C. Internal fixation of the lumbar spine with pedicle screw plating,Clin Orthop 1986; 203 : 7 – 17
Johnston CE II,Baird AM, Allard RM. Effect of spinal construct stiffness on early fusion mass incorporation : Experimental study Spine 1990 ; 15 : 908 – 12
Mcafee PC,Farey ID,Warden KE. Device – related osteoporosis with spinal instrumentation. Spine 1989 ; 14 : 919 – 26
Mcafee PC,Farey ID,Warden KE.The effect of spinal implant rigidity on vertebral bone densitometry. A canine model. Spine 1991 ; 165 : 190 – 7
Edward WT.Biomechanics of the spine : Spine stabilization . How much is enough ? North American spine society . Monterey , CA 1990
Gurr KR, Mcafee PC,Shih CH. Biomachanical analysis of anterior and Posterior instrumentation systems after corpectomy. J Bone Joint Surg 1988 ; 70 : 1182 – 91
Wu J, Shry JS, Kelly P. Comparison of osteotomy healing under external fixation devices with different stiffness characteristics. J Bone Joint Surg 1984 ; 66 : 1258 – 64
Goel VK, Lim TH, Gwon J, et al . Effect of rigidity of an internal fixation device : A comphrehensive biomechanical investigation. Spine 1991; 16 : 155 – 61
Anderson CE. Spondylolisthesis following spine fusion. J Bone Joint Surg 1956 ; 38 : 1142 – 6
Frymoyes JW, Matterri RE,Hanley EN,Howe J. Failed lumbar disc surgery requiring second operation : A long term follow – up study. Spine 1978 ; 3 : 7 – 11
Goldner JL. The role of spine fusion : Question 6. Spine 1981 ; 6 : 293 – 303
Harris RI, Willey JJ. Acquired spondylolysis as a sequel to spine fusion. J Bone Joint Surg 1963 ; 45 : 1159 – 70
Lee CK.Accelerated degeneration of the segment adjacent to lumbar fusion spine 1988 ; 13 : 375 – 7
Shono Y, Kaneda K, Abumi K, Cunningham BW.Stability of posterior spinal instrumentation and its effects on adjacent motion segments in the lumbosacral spine. Spine 1998 ; 23 : 1550 – 8
Mc culloch JA. Microdecompression and uninstrumented single – level fusion for spinal canal stenosis with degenerative spondylolisthesis. Spine 1998 ; 23 : 2243 – 52
Downloads
Published
How to Cite
Issue
Section
License
วารสารนี้เป็นลิขสิทธิ์ของโรงพยาบาลมหาสารคาม