Comparative study of unilateral versus bilateral pedicle screw fixation in the treatment of lumbar disc herniation

[Objective]To compare and analyze the clinical effects of unilateral and bilateral pedicle screw fixation.[Methods]From March 2008 to February 2010,a total of 61 cases of lumbar disc herniation with treatment of lumbar interbody fusion were divided into group A and B according to different surgical approaches.The 28 cases in group A(16 males,12 females,54.3±9.2 years of age) were treated with unilateral pedicle screw fixation by the paramedian approach.The 33 cases in group B(18 males,15 females,56.1±7.3 years of age) were treated with bilateral pedicle screw fixation by the traditional posterior median approach.The parameters including the ODI,VAS scores and fusion rates,etc.were analyzed.The improvement in the lumbar spine function and clinical effects of the surgery on the patients in the two groups were also evaluated and compared.[Results]Statistically significant differences of the operation time,intraoperative blood loss,postoperative flow of incision drain and hospitalization expenses were found between the two groups(P0.05).All the patients were followed up.The follow-up period of the group A ranged from 25 to 38 months(average 28.2 months),and the follow-up period of the group B ranged from 24 to 36 months(average 27.6 months).No screw loosening,displacement and breakage were found,and no cage displacement or settlement was observed during the follow-up period.At the final follow-up,no statistical difference of the VAS、ODI score,the excellent and good improvement rate and fusion rate were found between the two groups(P0.05).[Conclusion]The unilateral pedicle screw fixation can also achieve the satisfactory curative effect compared with the bilateral pedicle screw fixation.In addition,the former has characteristics of simple operative,less operation time,less blood loss,less flow of incision drain and lower hospitalization expenses,which can be the effective treatment for the unilateral lumbar disc herniation.