Clinical Outcome Study of Transfacet Fusion for Treatment of Herniated Lumbar Discs for Dynamic Stabilization (original) (raw)
2009, The Internet Journal of Minimally Invasive Spinal Technology
Objective of the study: The purpose of the present study is to present our experience and clinical results with surgical technique of discectomy and facet joint fusion. Our goal was to achieve pain free and stable back (segmental stability) after lumbar disc surgery and to assess the status of fusion and its relationship with clinical results.Study design :The proposed study is a prospective clinical study of low back pain/ leg pain due to prolapse intervertebral disc treated with discectomy with facet joint fusion (using titanium screws) A case of symptomatic disc prolapse not improving on at least six weeks of conservative management. Clinical and radiological follow up was done up to average of five years.Method: After laminectomy and disc removal. Denude the facet joint cartilage with help of fine curved curette and fine slivers of bone graft taken from spinous processes are impacted into facet joint space after distracting them with help of spreader. Titanium partially threaded cancellous screws with 2.7 mm drill bit without taping.Results Complete fusion across bilateral facets was achieved in 56.2 % levels. Partial fusion was achieved in 34.3% levels. No fusion at all was seen in only 3 levels (9.3%).On Applying chi square test between the 4 groups, chi square value came to be 44.92 with p value of < 0.001. This implied that Post-op Oswestry score & clinical results have statistically significant association with status of fusionConclusion: This study demonstrates that facet screw fixation has multiple advantages. The technique is not only easy to implement by placing a small screw through a facet joint without any excessive retraction of neural structures and any distraction of posterior elements thus preserving the segmental stability. It produces excellent clinical results that are comparable to other exhaustive surgical procedures and more bulky spinal instrumentation systems
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