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

Abstract

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...