Comparison of unilateral versus bilateral pedicle screw fixation in degenerative lumbar diseases: a meta-analysis

12 studies (n=865; 9 RCTs, 1 prospective, 2 retrospective) were included in this meta-analysis comparing the clinical outcomes between unilateral pedicle screw fixation to bilateral pedicle screw fixation in the treatment of degenerative lumbar diseases. Pooled results demonstrated bilateral fixation led to a significantly higher rate of successful fusion with, but was also associated with significantly higher intraoperative blood loss and operative time. The latter two results, were however, heterogeneous. Pooled results for clinical outcome measures (JOA, VAS, ODI, SF-36), total complications, and hospital stay were comparable between groups.