Clinical and radiological outcomes of unilateral versus bilateral instrumentation in two-level XXXX .

@entity1 @entity190 @entity1515 @entity179 @entity158 @entity717
PURPOSE: To compare the clinical and radiological outcomes of unilateral versus bilateral instrumented in two-level @entity179 after minimally invasive transforaminal lumbar interbody fusion (MITLIF). METHODS: We conducted a prospective cohort study of 74 @entity1 , who underwent unilateral or bilateral instrumented in two-level MITLIF for @entity179 from May 2010 to June 2012. There were 35 @entity1 in group A undergoing unilateral pedicle screw fixation and 39 @entity1 in group B undergoing bilateral pedicle screw fixation. Demographic data and clinical characteristics were compared between the two groups before surgery. Perioperative data, clinical and radiological outcomes of the two groups were also compared. RESULTS: The mean follow-up period was 32.1      7.5  months for group A and 31.7      8.0  months for group B (p  >  0.05). Group A required a significantly shorter operating time, lower implant costs and less intraoperative @entity190 and X-ray exposure time than group B (p  <  0.01). However, no statistical differences were identified in the amount of transfusion and postoperative hospital stay between the two groups (p  >  0.05). Clinical outcomes assessed by visual analog scores for back and leg @entity158 (VAS-BP and VAS-LP, respectively) and @entity717 Index (ODI) improved significantly in both groups after surgery, and no significant differences existed between the two groups at each postoperative follow-up (p  >  0.05). There were significant differences within groups for Cobb angles of the whole lumbar [Cobb (a)] and the @entity1515 at each time point before and after surgery (p  <  0.05). No significant differences existed between groups in relation to Cobb (a), Cobb angle of the fused segments, lumbar @entity1515 and the segmental @entity1515 at any time point before and after surgery (p  >  0.05). There were no significant differences in fusion rate and total complication rate between the two groups (p  >  0.05). CONCLUSIONS: Unilateral instrumentation after two-level MITLIF provided similar clinical and radiological outcomes to bilateral fixation in two-level @entity179 . Compared with bilateral fixation, unilateral fixation shortens operation time, reduces intra-operative @entity190 and X-ray exposure time, and saves medical expenses with similar postoperative hospital stay and complication rate.
