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Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review.

ABSTRACT: Study Design?Systematic review. Clinical Questions?(1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods?Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrumentation in spine surgery. Studies including recombinant human bone morphogenetic protein 2 as adjunct therapy and those with follow-up of less than 2 years were excluded. Results?Ten randomized controlled trials met the inclusion criteria: five compared unilateral with bilateral instrumentation using open transforaminal or posterior lumbar interbody fusion (TLIF/PLIF), one used open posterolateral fusion, and four used minimally invasive TLIF/PLIF. There were no significant differences between unilateral and bilateral screw instrumentation with respect to nonunion, low back or leg pain scores, Oswestry Disability Index, reoperation, or complications. Conclusions?The existing literature does not identify significant differences in clinical outcomes, union rates, and complications when unilateral instrumentation is used for degenerative pathologic conditions in the lumbar spine. The majority of published reports involve single-level lumbar unilateral instrumentation.

SUBMITTER: Molinari RW

PROVIDER: S-EPMC4472301 | biostudies-literature | 2015 Jun

REPOSITORIES: biostudies-literature

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Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review.

Molinari Robert W RW Saleh Ahmed A Molinari Robert R Hermsmeyer Jeff J Dettori Joseph R JR

Global spine journal 20150601 3

Study Design Systematic review. Clinical Questions (1) What is the comparative efficacy of unilateral instrumentation compared with bilateral instrumentation in spine surgery? (2) What is the safety of unilateral instrumentation compared with bilateral instrumentation in spine surgery? Methods Electronic databases and reference lists of key articles were searched up to September 30, 2014, to identify studies reporting the comparative efficacy and safety of unilateral versus bilateral instrumenta ...[more]

PMID: 26131385

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Dataset Information

Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review.

Publications

Unilateral versus Bilateral Instrumentation in Spinal Surgery: A Systematic Review.

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