65 patients diagnosed with degenerative lumbar spine disease were randomized to either unilateral or bilateral pedicle screw insertion in minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). The purpose of this study primarily was to compare clinical outcomes between the two instrumentation techniques from 6-18 months postoperatively. Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) pain scores improved in both groups, with no significant difference between groups detected at any time point. Fusion rate and complications were also similar between groups.