title: Prospective evaluation of 1-year outcomes in single-level percutaneous lumbar transfacet screw fixation in the lateral decubitus position following lateral transpsoas interbody fusion.
abstract: OBJECTIVE
  Lateral transpsoas lumbar interbody fusion (LTIF) is an accepted treatment for degenerative lumbar disc disease. Bilateral percutaneous transfacet (TF) fixation is a promising option for stabilization following LTIF. Here, we describe our experience with this technique and assess the clinical outcomes and efficacy.
  
  
  METHODS
  Thirty-eight consecutive patients were identified who underwent LTIF followed by bilateral percutaneous transfacet fixation in the lateral position. Preoperative and 1-year postoperative VAS scores, and operative data were prospectively recorded. One-year outcomes were also assessed according to the MacNab criteria. Fusion was assessed at 1 year via computed tomography and dynamic radiography. Two-tailed Student's t test was used to compare VAS scores.
  
  
  RESULTS
  Twenty-six patients underwent fusion at L4-5, 11 at L3-4, and one at L2-3; two patients were lost to follow-up. Mean operative time was 148.0 ± 47.9 min; mean blood loss was 33.0 ± 26.1 ml; mean hospital stay was 53.5 ± 51.2 h. Mean preoperative VAS scores for back and leg pain were 7.4 ± 3.0 and 7.0 ± 2.9, respectively; mean postoperative VAS scores for back and leg pain were 1.9 ± 2.4 (p < 0.0001) and 2.0 ± 3.0 (p < 0.0001), respectively. Most (89 %) patients had some relief, 72 % good to excellent and 17 % fair outcomes; eleven percent had little to no relief. There was one postoperative complication (pulmonary embolus). All patients had evidence of solid bony fusion.
  
  
  CONCLUSIONS
  Percutaneous transfacet fixation in the lateral position is a safe and effective alternative for fixation after LTIF and may be associated with shorter operative time and less blood loss than other posterior fixation techniques.
authors.affiliation: Department of Neurosurgery, Medstar Georgetown University Hospital, 3800 Reservoir Road, NW, PHC-7, Washington, DC, 20007, USA.
authors.forename: Jay W
authors.initials: JW
authors.lastname: Rhee
authors.affiliation: Department of Neurosurgery, Medstar Georgetown University Hospital, 3800 Reservoir Road, NW, PHC-7, Washington, DC, 20007, USA. rpetteys9@gmail.com.
authors.forename: Rory J
authors.identifier: http://orcid.org/0000-0003-2552-7661
authors.initials: RJ
authors.lastname: Petteys
authors.affiliation: Department of Neurosurgery, Medstar Georgetown University Hospital, 3800 Reservoir Road, NW, PHC-7, Washington, DC, 20007, USA.
authors.forename: Amjad N
authors.initials: AN
authors.lastname: Anaizi
authors.affiliation: Department of Neurosurgery, Medstar Georgetown University Hospital, 3800 Reservoir Road, NW, PHC-7, Washington, DC, 20007, USA.
authors.forename: Faheem A
authors.initials: FA
authors.lastname: Sandhu
authors.affiliation: Department of Neurosurgery, Medstar Georgetown University Hospital, 3800 Reservoir Road, NW, PHC-7, Washington, DC, 20007, USA. jmvoyadzis@gmail.com.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Voyadzis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000601:surgery*; D007866:Leg; D007902:Length of Stay; D017116:Low Back Pain / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D056888:Patient Positioning / Q000379:methods*; D011446:Prospective Studies; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery*
keywords: Lateral interbody fusion; Minimally invasive; Transfacet screw fixation