6533b830fe1ef96bd129709b

RESEARCH PRODUCT

Preliminary Experience with a Novel System of Facet Fixation to Treat Patients with Lumbar Degenerative Disease. A New Perspective in Minimally Invasive Spine Surgery?

Fabio BaroneMaria Pia PappalardoAntonino Odierna ContinoGabriele CostantinoFrancesco MeliDomenico Gerardo IacopinoAlessandro E. P. VillaCristina GalloNatale FrancavigliaRosario Maugeri

subject

musculoskeletal diseasesMalemicroinstabilitymedicine.medical_specialtyfacet wedgedegenerative lumbar diseaseRadiographyIntervertebral Disc DegenerationZygapophyseal Joint03 medical and health sciencesFixation (surgical)0302 clinical medicineLumbarDegenerative diseasemedicineHumansMinimally Invasive Surgical ProceduresSpinal canal030212 general & internal medicineHerniated diskAgedLumbar Vertebraemedicine.diagnostic_testSettore MED/27 - Neurochirurgiabusiness.industryMagnetic resonance imagingMiddle Agedmedicine.diseaseOswestry Disability IndexSurgerymedicine.anatomical_structureSpinal FusionTreatment Outcomefacet fluid signalSurgeryFemaleNeurology (clinical)facet fusionSpondylolisthesisbusiness030217 neurology & neurosurgeryIntervertebral Disc Displacement

description

Purpose We report our experience with a novel surgical device for the treatment of lumbar degenerative microinstability. Facet Wedge (DePuy Synthes, Raynham, Massachusetts, United States) is a novel technique of intra-articular lumbar facet fixation that provides a minimally invasive alternative to standard posterior fixation. Materials and Methods From November 2014 to July 2015, 38 patients underwent single-level Facet Wedge implantation. The main surgical indications included herniated disk (18 patients), spinal canal and foraminal stenosis (14 patients), and Meyerding grade I degenerative spondylolisthesis (6 patients). All the patients showed radiologic signs of microinstability: hyperintensity in both facet joints (facet fluid signal) in T2-weighted magnetic resonance imaging and a black disk as a sign of degenerative disease. No slippage was evident at dynamic radiograph. After a period of conservative treatment (minimum of 6 months), surgery was performed. All patients' follow-up lasted over at least 12 months. Results The low back visual analog scale score decreased significantly after surgery (from an average of 8.2 to 3.1 at final follow-up). Postoperatively, the Oswestry Disability Index showed a significant reduction (14.7 on average). No slippage or signs of adjacent segment degeneration was detected in neuroimaging follow-up. Conclusion Facet Wedge allows facet fixation in lumbar degenerative microinstability. To the best of our knowledge, this is the first clinical series reported in the literature on this novel device.

yearjournalcountryeditionlanguage
2017-10-17Journal of neurological surgery. Part A, Central European neurosurgery
10.1055/s-0037-1607196https://pubmed.ncbi.nlm.nih.gov/29041031