Effects of Unilateral and Bilateral Pedicle Screw Fixation on Lumbar Function and Spinal Morphology in Patients with Lumbar Degenerative Diseases during Minimally Invasive Transforaminal Lumbar Interbody Fusion
Objective To investigate the clinical efficacy of unilateral and bilateral pedicle fixation in minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)for the treatment of lumbar degenerative diseases.Methods 74 patients with lumbar degenerative diseases admitted to our hospital from June 2021 to June 2023 were selected as the research objects.According to the random number table method,they were divided into a control group and an observation group,with 37 cases in each group.Both groups were treated with MIS-TLIF.The observation group was treated with unilateral pedicle fixation,and the control group was treated with bilateral pedicle fixation.The operation condition,lumbar function,spinal morphology,pain score,dysfunction and complications were compared between the two groups.Results The operation time and hospitalization time in the observation group were(115.63±12.34)min and(9.86±1.15)d,respectively,which were shorter than(140.87±15.63)min and(11.89±1.24)d in the control group,the intraoperative blood loss was(105.63±10.41)mL,whihc was less than(168.96±16.75)mL of the control group,and the differences between the two groups were statistically significant(P＜0.05),there were no significant differences in Japanese Orthopaedic Association score and spinal morphology between the two groups before and 3 months after operation(P＞0.05).There were no significant differences in pain Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)score between the two groups before operation(P＞0.05).3 months after operation,the VAS score of the observation group was(1.35±0.22)points,which was lower than(1.87±0.26)points of the control group,the difference was statistically significant(P＜0.05);and there was no statistically significant difference in ODI scores between the two groups(P＞0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P＜0.05).Conclusion Both unilateral and bilateral pedicle screw fixation in MIS-TLIF can improve the condition of patients with lumbar degenerative diseases and accelerate the recovery of lumbar function,but unilateral pedicle screw fixation has less trauma and is beneficial to reduce complications.
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