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

Francaviglia, Natale; Costantino, Gabriele; Villa, Alessandro; Iacopino, Domenico Gerardo; Pappalardo, Maria Pia; Barone, Fabio; Gallo, Cristina; Contino, Antonino Odierna; Meli, Francesco; Maugeri, Rosario

doi:10.1055/s-0037-1607196

Cited by 6 publications

(10 citation statements)

References 41 publications

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“…38,[43][44][45][46][47] A few studies in this review presents a definition including facet effusion and facet angle as parameters. 22,36,48,49 The studies are published within the last decade. Signs of instability on MRI are subject of investigation and results indicate that facet effusion sign, sagittal facet angles, disc height and facet tropism might be linked to instability.…”

Section: Discussionmentioning

confidence: 99%

Radiological Definitions of Sagittal Plane Segmental Instability in the Degenerative Lumbar Spine – A Systematic Review

Elmose

Andersen

Carreon

et al. 2022

Global Spine Journal

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Study Design Systematic Review. Objective To collect and group definitions of segmental instability, reported in surgical studies of patients with lumbar spinal stenosis (LSS) and/or lumbar degenerative spondylolisthesis (LDS). To report the frequencies of these definitions. To report on imaging measurement thresholds for instability in patients and compare these to those reported in biomechanical studies and studies of spine healthy individuals.To report on studies that include a reliability study. Methods This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies eligible for inclusion were clinical and biomechanical studies on adult patients with LDS and/or LSS who underwent surgical treatment and had data on diagnostic imaging. A systematic literature search was conducted in relevant literature databases. Full text screening inclusion criteria was definition of segmental instability or any synonym. Two reviewers independently screened articles in a two-step process. Data synthesis presented by tabulate form and narrative synthesis. Results We included 118 studies for data extraction, 69% were surgical studies with decompression or fusion as interventions, 31% non-interventional studies. Grouping the definitions of segmental instability according similarities showed that 24% defined instability by dynamic sagittal translation, 26% dynamic translation and dynamic angulation, 8% used a narrative definition. Comparison showed that non-interventional studies with a healthy population more often had a narrative definition. Conclusion Despite a reputation of non-consensus, segmental instability in the degenerative lumbar spine can radiologically be defined as > 3 mm dynamic sagittal translation.

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Section: Discussionmentioning

confidence: 99%

Radiological Definitions of Sagittal Plane Segmental Instability in the Degenerative Lumbar Spine – A Systematic Review

Elmose

Andersen

Carreon

et al. 2022

Global Spine Journal

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“…Later, Francaviglia et al . [ 28 ] recruited 38 patients affected by herniated disk, spinal canal and foraminal stenosis, and Meyerding grade I degenerative spondylolisthesis to evaluate the safety and efficacy of FW and found that low back VAS score and ODI decreased significantly after surgery. Moreover, in neuroimaging follow-up slippage or signs of adjacent segment degeneration were not detected.…”

Section: Discussionmentioning

confidence: 99%

Lumbar facet joint stabilization for symptomatic spinal degenerative disease

Grasso

Musso

Buscemi

et al. 2022

Journal of Craniovertebral Junction and Spine

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Objective: Lumbar spinal degenerative disease (LSDD), unresponsive to conservative therapy, is commonly treated by surgical decompression and interbody fusion. Since facet joint incompetence has been suggested as responsible for the entire phenomenon of spinal degeneration, facet stabilization can be considered as an alternative technique to treat symptomatic spinal degenerative disease. The purpose of this study was to systematically review the literature for studies utilizing lumbar facet joint fixation techniques for LSDD to assess their safety and efficacy. Methods: A systematic literature review was performed following the preferred reporting items for systematic reviews and meta-analyses statement, with no limits in terms of date of publication. Demographic data, inclusion criteria, clinical and radiological outcome, frequency of adverse events (AEs), and follow-up time were evaluated. Results: A total of 19 studies were included with a total of 1577 patients. The techniques used for facet arthrodesis were Goel intra-articular spacers in 21 patients (5.3%), Facet Wedge in 198 patients (15.8%), facet screws fixation techniques in 1062 patients (52.6%), and facet joints arthroplasty in 296 patients (26.3%). Clinical outcomes were assessed through the evaluation of pain relief and improvement in functional outcome. Radiological outcomes were assessed by the evaluation of proper positioning of instrumentation, solid bony fusion rate, and preservation of disk height. AE's mainly observed were pseudoarthrosis, reoperation, instrumentation displacement/malpositioning/migration, neurological impairment, deep vein thrombosis, and infections. The mean follow-up time ranged from 6 months to 11.7 years. Conclusion: Our data demonstrate that facet joint arthrodesis appears to be effective in managing LSDD. These findings, however, are limited by the small sample size of patients. Accordingly, larger series are needed before formal recommendations can be made.

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“…За это время были зарегистрированы осложнения у 3 пациентов: у 2 -тромбоз глубоких вен нижних конечностей, у 1 -инфекция глубоких мягких тканей, что потребовало хирургического вмешательства. По данным рентгенологических исследований не выявлено каких-либо осложнений, связанных с не-стабильностью или поломкой металлоимплантатов [16]. Обобщенные данные вышеуказанных исследований представлены в таблице.…”

Section: материалы и методыunclassified

Facet fixation: an alternative to minimally-invasive posterior lumbar stabilization?

Epifanov

Lebedev

Ощепков

et al. 2020

Nejrohirurgiâ (Mosk.)

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The study objective is to analyze literature and evaluate based on the obtained data the effectiveness of decompression of neural structures using different methods of facet fixation.Materials and methods. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were used: full-text article in English, patient age above 19 years, presence of evaluation of the results of facet fixation, degenerative disease of the lumbar spine in patients.Results. First search in the PubMed database returned 198 results. Among them, 38 articles complied with the inclusion criteria, and 33 articles didn’t contain full data on patient outcomes in the context of the studied stabilization methods. The selected 5 articles contained data on treatment results, rates of fixation and complications. Many authors note good clinical effect and decreased rate of intra- and postoperative complications for facet fixation compared to transpedicular fixation.Study limitations. Absence of systematic reviews and availability of only 1 article for each method of facet fixation. Small patient samples and short follow-up.Conclusion. Decompression and facet fixation in a single spinal motion segment in combination with posterior lumbar, transforaminal and lateral lumbar interbody fixation including use of minimally invasive technologies and other methods in many cases allows to achieve good clinical effect and firm stabilization.

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

Abstract: 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.

Cited by 6 publications

References 41 publications

Radiological Definitions of Sagittal Plane Segmental Instability in the Degenerative Lumbar Spine – A Systematic Review

Radiological Definitions of Sagittal Plane Segmental Instability in the Degenerative Lumbar Spine – A Systematic Review

Lumbar facet joint stabilization for symptomatic spinal degenerative disease

Facet fixation: an alternative to minimally-invasive posterior lumbar stabilization?

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