Transforaminal lumbar interbody fusion (TLIF) is one of the surgical options used for the treatment of lumbar degenerative disease. However, it still remains unknown whether TLIF with unilateral pedicle screw (PS) fixation is superior to that with bilateral PS fixation. This meta-analysis was performed to compare the relative benefits and risks of unilateral and bilateral PS fixation in TLIF for the treatment of lumbar degenerative disease. Methods: Medline, Embase, and the Cochrane Central

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... ster of Controlled Trials databases were searched to identify relevant randomized controlled trials (RCTs). All data were analyzed by Review Manager 5.3 software. A random effect model was used for heterogeneous data; otherwise, a fixed effect model was used. Results: Eleven ran-domized and one quasi-randomized controlled trials were retrieved in the meta-analysis. Overall, there were significant differences between the two groups for operative time and blood loss. No significant differences were detected regarding fusion rate, total complication rate, dura tear, superficial wound infection, screw-related complications, reoperation rate, visual analog scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopedic Association (JOA), the Short Form (36) Health Survey (SF-36) scores, and hospital stay. Conclusions: This meta-analysis showed that unilateral fixation group was superior to bilateral fixation group regarding operative time and blood loss. However, the results of fusion rate, total complication rate, specific complications, reoperation rate, functional outcomes and hospital stay were similar in the two groups. Therefore, the results of this study indicate that unilateral PS fixation in TLIF is a good alternative to bilateral PS fixation for the treatment of lumbar degenerative disease.