ReviewSurgical neurology international2026
Is there a difference in unilateral versus bilateral facetectomy in an open or minimally invasive surgery transforaminal lumbar interbody fusion? A systematic review and meta-analysis.
Review in Surgical neurology international, 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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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.
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5 authors.
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Abstract
Background: Transforaminal lumbar interbody fusion (TLIF) is widely used to treat degenerative spinal pathologies. However, deciding whether to use a unilateral or bilateral facetectomy has historically been based on surgeon preference. This study aims to compare radiological, operative, and clinical outcomes of unilateral versus bilateral facetectomy in open or minimally invasive surgery (MIS) TLIF. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, nine cohort studies were identified: two open-only, six MIS-only, and one combined MIS-open TLIF publications. Forest plots generated a pooled analysis for each outcome measure. Results: Meta-analyses found no difference in lumbar lordosis between facetectomy procedures in open-only, MIS-only, or combined groups. Disc height change was similar in the MIS-only and combined groups. In MIS-only publications, bilateral facetectomy was associated with higher blood loss, postoperative drainage, and surgical duration. One open-only publication reported that bilateral facetectomy experienced statistically significantly greater delta patient health questionnaire-9 (-4.6 ± 5.2 vs. -0.8 ± 4.6, Conclusion: Unilateral and bilateral facetectomy produce comparable radiologic, operative, and clinical outcomes. In MIS TLIF, unilateral facetectomy offers reduced blood loss, operative time, and drainage. Unilateral facetectomy is an acceptable and potentially favorable option for standard lumbar degeneration, particularly in MIS TLIF, where exposure is limited to a facet.
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