Evidence map›Paper›PMID 40998698›Full record

ArticleInternational journal of spine surgery2026

Bilateral Pedicle Screw Fixation Vs Unilateral Pedicle Screw Fixation for Single Level Lateral Lumbar Interbody Fusion: Outcomes, Cost Analysis, and Radiation Exposure.

Saagar Dhanjani, Timothy Choi, Abdufarrukh Karimov, Kishan S Shah, Micah B Blais, Gregory M Mundis, Ali Bagheri, Behrooz A Akbarnia, Robert K Eastlack

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Article in International journal of spine surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Saagar DhanjaniShiley Center for Orthopedic Research and Education, Scripps Clinic, La Jolla, CA, US.
Timothy ChoiDepartment of Orthopedic Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
Abdufarrukh KarimovDepartment of Orthopedic Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
Kishan S ShahShiley Center for Orthopedic Research and Education, Scripps Clinic, La Jolla, CA, US.
Micah B BlaisDepartment of Orthopedic Surgery, University of California San Diego, La Jolla, CA, USA.
Gregory M MundisDepartment of Orthopedic Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
Ali BagheriDepartment of Orthopedic Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA.
Behrooz A AkbarniaDepartment of Research, San Diego Spine Foundation, San Diego, CA, USA.
Robert K EastlackDepartment of Orthopedic Surgery, Scripps Clinic Medical Group, La Jolla, CA, USA eastlack.robert@scrippshealth.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aims to determine whether single-level lateral lumbar interbody fusion (LLIF) with unilateral pedicle screw fixation (UPSF) might offer advantages over bilateral pedicle screw fixation (BPSF) in terms of radiation emission, cost, and outcomes.

methodsThe records of 101 patients who underwent single-level LLIF with percutaneous pedicle screw fixation from September 2017 to August 2024 were analyzed. Patients were divided into 2 groups: 42 with UPSF and 59 with BPSF. Demographic data, social history, comorbidities, surgical characteristics, costs (based on manufacturer prices), and radiation metrics (radiation emitted, fluoroscopy time, number of images, and magnification mode used) were collected. Clinical outcomes were assessed using the Numeric Rating Scale (NRS), the Oswestry Disability Index, and procedure satisfaction, while radiographic evaluation employed a novel fusion classification system.

resultsThere were no significant differences in age, body mass index, social history, comorbidities, or operative level. However, the BPSF group included significantly more women (

conclusionsOur study found that when used according to clinical indications, UPSF results in similar radiation emission and radiographic outcomes, while being 27.7% less expensive than BPSF for single-level LLIF. Additionally, while BPSF was associated with greater improvement in 1 year NRS back scores, no other significant differences in patient-reported outcome measures were observed between the 2 groups. CLINICAL RELEVANCE: This study provides clinically relevant insights for selecting between UPSF and BPSF in single-level LLIF when both are considered appropriate. LEVEL OF EVIDENCE: 3:

Indexed as

bilateral pedicle screw fixationclinical outcomescost analysislateral lumbar interbody fusionradiation exposureradiographic outcomesunilateral pedicle screw fixation

Identifiers

PMID40998698
PMCPMC13036451

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.