Biomechanical Analysis of Unilateral Fixation With Interbody Cages

Abstract

In the group of unilateral fixation combining PLIF with two cages, the anterior support of cages enabled unilateral instrumentation to restore torsional stiffness and other spinal stability indexes. Considering the initial stability and the load-sharing effect, this study showed that the unilateral fixation combining PLIF and two cages might be a good alternative to spinal fixation.

Unilateral versus bilateral instrumented transforaminal lumbar interbody fusion in two-level degenerative lumbar disorders: a prospective randomised study

“…Unilateral pedicle screw fixation has been previously studied biomechanically and clinically. Some biomechanical studies using cadaver specimens have indicated that the unilateral instrumented TLIF procedure provides less rotational stability and stiffness than bilateral pedicle screw fixation, but whether the more rigid fixation is needed was controversial [8,23]. Encouraging results can be achieved by unilateral fixation with an anterior supporting device such as an interbody cage [23].…”

“…[17][18][19]. Some clinical and biomechanical studies on the suitability of unilateral pedicle screw fixation have demonstrated that reliable fusion with fewer pedicle screws can be achieved [11][12][13][20][21][22][23]. Therefore, the need for unilateral or bilateral instrumentation is a matter for debate.…”

Unilateral pedicle screw fixation through a tubular retractor via the Wiltse approach compared with conventional bilateral pedicle screw fixation for single-segment degenerative lumbar instability: a prospective randomized study

“…U nilateral pedicle screw fixation has been found to achieve stability and fusion rates similar to those of bilateral pedicle screw fixation in the treatment of patients with single-segment degenerative lumbar instability, 1,3,7,12,18 as well as in the treatment of patients with double-segment degenerative lumbar instability. 3,18 However, these studies used conventional lumbar fusion surgery that has drawbacks, such as the need for extensive soft tissue dissection with resulting iatrogenic tissue injury, which can lead to increased pain postoperatively, longer recovery duration, and impairment of spinal function.…”

Reply to Letter to the Editor: Surgical Technique: Hemilaminectomy and Unilateral Lateral Mass Fixation for Cervical Ossification of the Posterior Longitudinal Ligament

“…It is true that the hemilaminectomy approach may provide a relatively narrow exposure of the spinal canal, but does more decompression lead to a better clinical result? The surgical results for multilevel continuous/mixed cervical ossification of posterior longitudinal ligament involves various aspects, including neurological function and complications (especially C5 palsy and kyphosis) at short-and long-term followup.Previous studies [1,3] reported that unilateral fixation had comparable efficacy to bilateral fixation in lumbar spinal fusion. Unilateral fixation is one of the remarkable novel ideas of this technique.…”

“…Previous studies [1,3] reported that unilateral fixation had comparable efficacy to bilateral fixation in lumbar spinal fusion. Unilateral fixation is one of the remarkable novel ideas of this technique.…”