8 randomized controlled trials (545 patients) were used in this meta-analysis analyzing the safety and efficacy of unilateral pedicle screw fixation and bilateral pedicle screw fixation in patients with degenerative lumbar disease. Results indicated that unilateral pedicle screw fixation with cage fusion achieved similar VAS, ODI, SF-36 scores, fusion rate, complication rate and blood loss to bilateral screw fixation, as well as significantly shorter operative time. However, heterogeneity, small sample sizes, and short follow-up periods indicate the need for further trials in order to draw definitive conclusions.