Abstract：
METHODS: Prospective randomized controlled trial.
OBJECTIVE: No prospective studies have directly compared clinical and radiographic outcomes of unilateral vs bilateral instrumented lateral lumbar interbody fusion (LLIF) for lumbar degenerative disease (LDD). We compared the short-term radiographic, clinical outcomes, and some complications of the unilateral percutaneous pedicle screw (PPS) (UPS) vs bilateral PPS (BPS) fixation in short-level spinal fusion with LLIF for LDD.
METHODS: This was a prospective randomized controlled study of 33 patients who underwent UPS or BPS fixation after LLIF for LDD; 18 patients were assigned to the UPS group and 15 patients to the BPS group. Clinical outcomes, complication rates, and fusion rates were assessed.
RESULTS: The two groups were similar in age, sex, preoperative diagnosis, and level of surgery. Blood loss, length of hospital stay, and numeric rating scale score one year after surgery did not differ between groups. The operative time was longer in the BPS than UPS group (120.2 vs 88.8 min, respectively; P = .029). Both groups showed improvement in disc height and dural sac in the immediate postoperative computed tomography and magnetic resonance imaging, which did not differ significantly between groups. The subsidence grade and fusion rate did not differ, but cage subsidence was more severe in the UPS than BPS group.
CONCLUSIONS: Unilateral and bilateral PPS fixation after LLIF yielded similar short-term clinical and radiological outcomes. However, severe cage subsidence was more common in the UPS group, which suggests that BPS fixation after LLIF may be a better choice over the long term.
OBJECTIVE: No prospective studies have directly compared clinical and radiographic outcomes of unilateral vs bilateral instrumented lateral lumbar interbody fusion (LLIF) for lumbar degenerative disease (LDD). We compared the short-term radiographic, clinical outcomes, and some complications of the unilateral percutaneous pedicle screw (PPS) (UPS) vs bilateral PPS (BPS) fixation in short-level spinal fusion with LLIF for LDD.
METHODS: This was a prospective randomized controlled study of 33 patients who underwent UPS or BPS fixation after LLIF for LDD; 18 patients were assigned to the UPS group and 15 patients to the BPS group. Clinical outcomes, complication rates, and fusion rates were assessed.
RESULTS: The two groups were similar in age, sex, preoperative diagnosis, and level of surgery. Blood loss, length of hospital stay, and numeric rating scale score one year after surgery did not differ between groups. The operative time was longer in the BPS than UPS group (120.2 vs 88.8 min, respectively; P = .029). Both groups showed improvement in disc height and dural sac in the immediate postoperative computed tomography and magnetic resonance imaging, which did not differ significantly between groups. The subsidence grade and fusion rate did not differ, but cage subsidence was more severe in the UPS than BPS group.
CONCLUSIONS: Unilateral and bilateral PPS fixation after LLIF yielded similar short-term clinical and radiological outcomes. However, severe cage subsidence was more common in the UPS group, which suggests that BPS fixation after LLIF may be a better choice over the long term.
摘要：
方法：前瞻性随机对照试验。
目的：目前还没有前瞻性研究直接比较单侧与双侧腰椎外侧植骨融合术（LLIF）治疗腰椎退行性疾病（LDD）的临床和影像学结果。我们比较了短期射线照相，临床结果，单侧经皮椎弓根螺钉（PPS）（UPS）与双侧PPS（BPS）固定在短级别脊柱融合术中与LLIF治疗LDD的一些并发症。
方法：这是一项前瞻性随机对照研究，对33例患者进行了LDDLLIF后接受UPS或BPS固定治疗；其中18例患者被分配到UPS组，15例患者被分配到BPS组。临床结果,并发症发生率,并评估融合率。
结果：两组年龄相似，性别,术前诊断,和手术水平。失血,住院时间,术后1年的数字评定量表评分在组间没有差异.BPS组的手术时间长于UPS组（120.2vs88.8分钟，分别为；P=0.029）。两组术后即刻计算机断层扫描和磁共振成像显示椎间盘高度和硬膜囊改善，两组之间没有显着差异。沉降等级和融合率没有差异，但UPS组网箱沉降比BPS组严重。
结论：LLIF后单侧和双侧PPS固定产生相似的短期临床和放射学结果。然而,严重的网箱沉降在UPS组中更为常见，这表明，从长远来看，LLIF后的BPS固定可能是一个更好的选择。
目的：目前还没有前瞻性研究直接比较单侧与双侧腰椎外侧植骨融合术（LLIF）治疗腰椎退行性疾病（LDD）的临床和影像学结果。我们比较了短期射线照相，临床结果，单侧经皮椎弓根螺钉（PPS）（UPS）与双侧PPS（BPS）固定在短级别脊柱融合术中与LLIF治疗LDD的一些并发症。
方法：这是一项前瞻性随机对照研究，对33例患者进行了LDDLLIF后接受UPS或BPS固定治疗；其中18例患者被分配到UPS组，15例患者被分配到BPS组。临床结果,并发症发生率,并评估融合率。
结果：两组年龄相似，性别,术前诊断,和手术水平。失血,住院时间,术后1年的数字评定量表评分在组间没有差异.BPS组的手术时间长于UPS组（120.2vs88.8分钟，分别为；P=0.029）。两组术后即刻计算机断层扫描和磁共振成像显示椎间盘高度和硬膜囊改善，两组之间没有显着差异。沉降等级和融合率没有差异，但UPS组网箱沉降比BPS组严重。
结论：LLIF后单侧和双侧PPS固定产生相似的短期临床和放射学结果。然而,严重的网箱沉降在UPS组中更为常见，这表明，从长远来看，LLIF后的BPS固定可能是一个更好的选择。
