Biomechanical evaluation of the Facet Wedge: a refined technique for facet fixation

Hartensuer, René; Riesenbeck, Oliver; Schulze, Martin; Gehweiler, Dominic; Raschke, Michael J.; Pavlov, Paul W.; Wähnert, Dirk

doi:10.1007/s00586-014-3533-2

Cited by 28 publications

(27 citation statements)

References 24 publications

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“…Intra-facet joint implants (wedge body/spacers) inserted into the facet joint space to engage the opposing joint surfaces can provide necessary distraction for stabilization (Figure 3d ) (132). The implants could also improve rotational stability (133). A clinical study reported an excellent outcome for 25 out of 36 patients (134).…”

Section: Facet Joint Fusion Systemsmentioning

confidence: 99%

Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

O’Leary

Paschos

Link

et al. 2018

Annu. Rev. Biomed. Eng.

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The zygapophysial joint, a diarthrodial joint commonly referred to as the facet joint, plays a pivotal role in back pain, a condition that has been a leading cause of global disability since 1990. Along with the intervertebral disc, the facet joint supports spinal motion and aids in spinal stability. Highly susceptible to early development of osteoarthritis, the facet is responsible for a significant amount of pain in the low-back, mid-back, and neck regions. Current noninvasive treatments cannot offer long-term pain relief, while invasive treatments can relieve pain but fail to preserve joint functionality. This review presents an overview of the facet in terms of its anatomy, functional properties, problems, and current management strategies. Furthermore, this review introduces the potential for regeneration of the facet and particular engineering strategies that could be employed as a long-term treatment.

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Section: Facet Joint Fusion Systemsmentioning

confidence: 99%

Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

O’Leary

Paschos

Link

et al. 2018

Annu. Rev. Biomed. Eng.

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“…Obviously their application has to be evaluated on the basis of a careful preoperative radiological planning. Up to date there aren't in literature clinical trials about the effective of this technique [17][18][19]. The biomechanical concept of this device, the possibility of implanting in percutaneous technique and in combined instrumentation with anterior cages or different posterior fusion techniques, could reveal that this technique might be an effective and feasible alternative which needs to be addressed in further studies.…”

Section: Discussionmentioning

confidence: 99%

Facet Wedge Fixation in Lumbar Spine Degenerative Pathology: A New Option for Minimally-Invasive Posterior Approach?

Aless¹,

L²,

Fazzolari³

et al. 2015

Orthop Muscul Syst

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In recent years spinal surgery has undergone a drastic change of course, mainly due to the increasing use of minimally invasive and percutaneous techniques for the treatment of lumbar spine degenerative pathology. This has led to the development of techniques more effective (for the pathology) and less invasive (for the patient). Recently the technological progress focused on a very specific vertebral fusion technique: the facet joint fixation. This technique has already been described in past as available with the assistance of autologous bone chips into the facet joint; nowadays it has been brought up to date by the development and use of an implantable device that promotes the bone fusion of the joint complex: the Facet-Wedge®. The employment of this device seems to offer a minimally invasive choice to the standard posterior screws fixation techniques for the treatment of selected cases of lumbar degenerative pathologies. Obviously their application has to be evaluated on the basis of a careful preoperative radiological planning. Up to date there aren't in literature clinical trials about the effective of this device and this technique. The biomechanical meaning of this device, the possibility of implanting in percutaneous technique and in combined instrumentation with anterior cages or different posterior techniques, could reveal that this technique might be an effective and feasible alternative, which needs to be addressed in further studies.

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“…Biomechanical and clinical trials confirmed low injury rate, relative simplicity and significantly lower risks of damaging the spinal canal content as compared to bilateral transpedicular stabilization, with fixation rigidity remaining comparable [25,26].…”

Section: Excellentmentioning

confidence: 99%

Treatment of Patients with Degenerative Diseases of the Lumbosacral Spine Using a Novel Technology of Facet Stabilization with Facet Wedge Implant

Калинин¹,

Okoneshnikova²,

Byvaltsev³

2017

Sovrem Tehnol Med

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Russian FederationTranspedicular fixation with interbody fusion widely used in management of degenerative diseases of the lumbosacral spine is associated with significant intraoperative aggression during surgery and postsurgical pain syndrome. To improve treatment results, a novel minimally invasive technology of facet fixation with Facet wedge implant in combination with transpedicular stabilization and interbody fusion has been introduced.The aim of the investigation was to evaluate the efficacy of facet fixation technology with Facet wedge implant in combination with transpedicular stabilization and interbody fusion in treatment of patients with degenerative diseases of the lumbosacral spine.Materials and Methods. The study involved 19 patients who underwent unilateral decompression with transforaminal lumbar interbody fusion, ipsilateral transpedicular stabilization and facet fixation on the contralateral side, according to clinical and instrumental indications. The minimum follow-up period of observation and complex evaluation of treatment results was 12 months.Results. when assessing pain syndrome by visual analogue scale and the degree of disability according to Oswestry disability index in the early postoperative period and in the long-term period, mostly good and excellent outcomes, statistically significantly better results were observed compared to the preoperative values. an interbody bone block was formed within 12 months in 89% (n=17) of patients, according to radiographic data.Conclusion. Decompression with a novel minimally invasive technology of combined dorsal fusion provides the possibility to significantly reduce pain, lower the degree of disability and implement efficient stabilization of the operated functional spinal segment in patients with degenerative diseases of the lumbosacral spine.Key words: stabilization of facet joints; transpedicular fixation; spinal canal decompression; lumbosacral spine; degenerative lesion of the intervertebral disc; TLIF.For contacts: Vadim a. Byvaltsev, e-mail: byval75vadim@yandex.ru Facet Stabilization in Degenerative Diseases of the Lumbosacral SpineMany degenerative diseases of the lumbosacral spine are the indication for performing interbody fusion [1,2]. Transpedicular fixation of interbody cages has been the gold standard in effective stabilization of vertebral motion segments after resection of posterior supporting elements for decompression of spinal canal structures [3, 4].The method of transforaminal lumbar interbody fusion (TLIF), first introduced by Harms and Rolinger in 1982 [5], has gained popularity in the last two decades. The advantages of transforaminal interventions over the classical posterior interbody fusion have been confirmed by a number of studies: low risks of damage to dura mater and the spinal roots, lower blood loss, better bone block formation [6,7]. However, some authors evidence the significant injury of paravertebral tissues and muscular-ligamentous apparatus resulting from such interventions and contributing to the formatio...

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Biomechanical evaluation of the Facet Wedge: a refined technique for facet fixation

Abstract: Facet Wedge offers a novel posterior approach in achieving primary stability in lumbar spinal fixation. The results of the present study showed that the Facet Wedge has a comparable primary stability to pedicle screws and potential advantages over translaminar screws.

Cited by 28 publications

References 24 publications

Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

Facet Joints of the Spine: Structure–Function Relationships, Problems and Treatments, and the Potential for Regeneration

Facet Wedge Fixation in Lumbar Spine Degenerative Pathology: A New Option for Minimally-Invasive Posterior Approach?

Treatment of Patients with Degenerative Diseases of the Lumbosacral Spine Using a Novel Technology of Facet Stabilization with Facet Wedge Implant

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