40 patients undergoing transforaminal lumbar interbody fusion (TLIF) were randomized to one of two groups. One group underwent the procedure with bilateral pedicle screw fixation, while the other underwent unilateral pedicle screw fixation and contralateral translaminar facet joint screw fixation. The purpose of this study was to compare various outcomes between the methods including operative time, blood loss, clinical measures and fusion rate over 1 year postoperatively. Results demonstrated no significant differences between groups in clinical outcomes or rate of successful fusion. Combined fixation with unilateral pedicle screws and a contralateral facet joint screw was associated with significantly shorter operative time and lower blood loss compared to bilateral pedicle screw fixation.