Abstract: Objective To investigate the effect of unilateral versus bilateral pedicle screw fixation with transforaminal lumbar interbody fusion in patients with lumbar degenerative disease,aims to explore the treatment of lumbar retrograde changes effective treatment,to provide basis for clinical treatment. Methods A total of 117 lumbar degenerative disease patients were divided into unilateral fixation group (52 cases) and bilateral fixation group (52 cases) from October,2010 to June,2014.All patients were followed up for more than 2 years.To compare operation time,intraoperative blood loss,lumbar spine fusion,complications,degeneration of adjacent segments and Cobb angle of lumbar vertebrae in 2 groups. Results The operation time and intraoperative blood loss of unilateral fixation group were significantly less than those in bilateral fixation group (P<0.05);There was no significant difference in fusion rate between 2 groups at 6 months,1 year and 2 years after operation (P>0.05).There was no serious complication in the two groups.At the last follow-up,the degeneration rate of adjacent segments of unilateral fixation group was 33.93%,and the degeneration rate of adjacent segments of bilateral fixation group was 65.57%,the degeneration rate of adjacent segments of unilateral fixation group was lower than that in bilateral fixation group (P<0.05),and the rate was significantly lower than that of bilateral fixation group (P<0.05);There was no significant difference in the Cobb angle between 2 groups at end of operation,3 months after operation,6 months after operation and 2 years after operation (P>0.05). Conclusion Unilateral and bilateral pedicle screw fixation with transforaminal lumbar interbody fusion in patients with lumbar degenerative disease,can obtain satisfactory treatment,but unilateral pedicle screw fixation has short,operation time,little blood loss,adjacent segment degeneration was significantly more low.