Clinical analysis of percutaneous facet screw fixation after anterior lumbar interbody fusion.
OBJECTIVE
The authors performed a retrospective study to evaluate the results of percutaneous facet screw fixation (PFSF) after anterior lumbar interbody fusion (ALIF) in comparison with the gold standard, post-ALIF pedicle screw fixation (PSF).


METHODS
Of 84 patients treated for degenerative spondylolisthesis or degenerative disc disease at the authors' institution, 44 underwent PFSF (Group 1) and 40 underwent PSF (Group 2 [control population]) after ALIF. Function was assessed using the Oswestry Disability Index (ODI) scoring system, and outcome was measured using the Macnab criteria. At 3, 6, 12, and 24 months after surgery, dynamic lateral (flexion-extension) radiography and computerized tomography scanning were conducted to evaluate the osseous union status. After a minimum follow-up period of 2 years, analysis showed no intergroup statistical difference in terms of ODI score and Macnab outcome criteria (p > 0.05). Excellent or good outcome was obtained in 40 (90.9%) of the 44 patients in Group 1 and 37 (92.5%) of the 40 patients in the control Group 2 (p > 0.05). No patient required a blood transfusion in either group. At 24 months after surgery fusion rates were 95.8% in Group 1 and 97.5% in Group 2.


CONCLUSIONS
The results of PFSF following ALIF appear to be clinically equivalent to those achieved after PSF, and the procedure represents a safe and minimally invasive modality with which to achieve solid fusion in the lumbar spine.
Jang
Jee-Soo
JS
Department of Neurosurgery, Gimpo Airport Wooridul Spine Hospital, Seoul, Korea. spinejjs@yahoo.co.kr
Lee
Sang-Ho
SH
D000368:Aged; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery*; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery*