Unilateral vs Bilateral Cages in Lumbar Interbody Fusions: A Meta-Analysis of Clinical and Radiographic Outcomes.
Interbody fusion
bilateral
cage
pseudoarthrosis
unilateral
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
30 Mar 2024
30 Mar 2024
Historique:
received:
18
03
2024
accepted:
25
03
2024
medline:
2
4
2024
pubmed:
2
4
2024
entrez:
1
4
2024
Statut:
aheadofprint
Résumé
Bilateral cages are often used for interbody fusion. However, this procedure may not be possible in some cases making unilateral cages a reasonable alternative. The literature remains divided on the clinical and radiological distinctions when comparing unilateral to bilateral cages in lumbar interbody fusion. Thus, this meta-analysis will analyze the clinical and radiographic outcomes between these two groups. PubMed, Cochrane, and Google Scholar (page 1-20) were searched till January 2024. The clinical outcomes evaluated were the incidence of adverse events, surgery-related parameters, and patient reported outcomes. Lower rates of pseudoarthrosis, subsidence, were reported in the bilateral cages group (p=0.01, p=0.001, respectively) whereas shorter operative time (OR time), and lower estimated blood loss (EBL) were seen in unilateral cage group (p<0.001, and p=0.003). There was no statistically significant difference in the remaining analyzed outcomes. Unilateral cages were shown to be superior due to their reduced OR time and EBL. As for the higher rate of pseudoarthrosis, this outcome may not be related to the cage numbers and it did not affect clinical outcomes. Nevertheless, one must consider other factors such as radiographic sagittal parameters before making a surgical decision.
Sections du résumé
BACKGROUND
BACKGROUND
Bilateral cages are often used for interbody fusion. However, this procedure may not be possible in some cases making unilateral cages a reasonable alternative. The literature remains divided on the clinical and radiological distinctions when comparing unilateral to bilateral cages in lumbar interbody fusion. Thus, this meta-analysis will analyze the clinical and radiographic outcomes between these two groups.
METHODS
METHODS
PubMed, Cochrane, and Google Scholar (page 1-20) were searched till January 2024. The clinical outcomes evaluated were the incidence of adverse events, surgery-related parameters, and patient reported outcomes.
RESULTS
RESULTS
Lower rates of pseudoarthrosis, subsidence, were reported in the bilateral cages group (p=0.01, p=0.001, respectively) whereas shorter operative time (OR time), and lower estimated blood loss (EBL) were seen in unilateral cage group (p<0.001, and p=0.003). There was no statistically significant difference in the remaining analyzed outcomes.
CONCLUSION
CONCLUSIONS
Unilateral cages were shown to be superior due to their reduced OR time and EBL. As for the higher rate of pseudoarthrosis, this outcome may not be related to the cage numbers and it did not affect clinical outcomes. Nevertheless, one must consider other factors such as radiographic sagittal parameters before making a surgical decision.
Identifiants
pubmed: 38561031
pii: S1878-8750(24)00528-X
doi: 10.1016/j.wneu.2024.03.142
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.