Unilateral pedicle screw fixation with transforaminal interbody fusion (UNILIF): 52-patient prospective series

Abstract

Introduction: The success of lumbar spine fusion depends on good patient selection. Bilateral pedicle instrumentation whit transforaminal interbody fusion, now popular, improves fusion rates, and eliminates the necessity for postoperative braces, also allows early mobilization. However, the stress shielding caused by rigid internal fixation is thought to lead to osteopenia and degeneration of adjacent segments. Theatre times, intra-operative complications and costs are increased when pedicle screw fixation is added. The following report is a 52-patient prospective study, with lumbar degenerative disease treated with unilateral pedicle screw fixation plus transforaminal lumbar interbody fusion (UNILIF). We examined the clinical outcomes, fusion rates and also the complications. Material and methods: Prospectively collected clinical and radiological data on patients with degenerative lumbar disease managed by UNILIF. From January 2014 to January 2018, we prospectively collected clinical and radiological data on patients with degenerative lumbar disease managed by UNILIF. Preoperatively and at 2 years, we recorded ODI and VAS. Interbody fusion was analyzed on radiography and on a CT scan. Results: Mean operation time was 93.5 min±16.8, mean blood loss was 130.8 ml±210.9. ODI and VAS were significantly improved (p < 0.005). The fusion rate was 96.8% on radiographic analysis and was 95.9% on CT scan analysis. A loosening of the screw was reported, without pain. He was treated with rest and physical therapy, with good evolution. No infections were reported. Conclusion: Although it is a small group, but with a long follow-up, the UNILIF technique has been shown to be effective and safe for patients with lumbar degenerative disease.