J Neurol Surg A Cent Eur Neurosurg 2018; 79(04): 296-301
DOI: 10.1055/s-0037-1607196
Original Article
Georg Thieme Verlag KG Stuttgart · New York

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

Natale Francaviglia
1  Department of Neurosurgery, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Civico Di Cristina Benfratelli, Palermo, Sicilia, Italy
,
Gabriele Costantino
2  Department of Neurosurgery, ARNAS Civico Hospital, Palermo, Italy
,
Alessandro Villa
2  Department of Neurosurgery, ARNAS Civico Hospital, Palermo, Italy
,
Domenico Gerardo Iacopino
3  Department of Experimental Biomedicine and Clinical Neurosciences, AOU Policlinico Paolo Giaccone, Palermo, Italy
,
Maria Pia Pappalardo
4  Department of Neuro Radiology, ARNAS Civico Hospital, Palermo, Italy
,
Fabio Barone
4  Department of Neuro Radiology, ARNAS Civico Hospital, Palermo, Italy
,
Cristina Gallo
4  Department of Neuro Radiology, ARNAS Civico Hospital, Palermo, Italy
,
Antonino Odierna Contino
1  Department of Neurosurgery, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Civico Di Cristina Benfratelli, Palermo, Sicilia, Italy
,
Francesco Meli
2  Department of Neurosurgery, ARNAS Civico Hospital, Palermo, Italy
,
Rosario Maugeri
5  Department of Neurosurgery, Università degli Studi di Palermo, Palermo, Italy
› Author Affiliations
Further Information

Publication History

21 February 2017

17 July 2017

Publication Date:
17 October 2017 (online)

Abstract

Purpose We report our experience with a novel surgical device for the treatment of lumbar degenerative microinstability. Facet Wedge (DePuy Synthes, Raynham, Massachusetts, United States) is a novel technique of intra-articular lumbar facet fixation that provides a minimally invasive alternative to standard posterior fixation.

Materials and Methods From November 2014 to July 2015, 38 patients underwent single-level Facet Wedge implantation. The main surgical indications included herniated disk (18 patients), spinal canal and foraminal stenosis (14 patients), and Meyerding grade I degenerative spondylolisthesis (6 patients). All the patients showed radiologic signs of microinstability: hyperintensity in both facet joints (facet fluid signal) in T2-weighted magnetic resonance imaging and a black disk as a sign of degenerative disease. No slippage was evident at dynamic radiograph. After a period of conservative treatment (minimum of 6 months), surgery was performed. All patients' follow-up lasted over at least 12 months.

Results The low back visual analog scale score decreased significantly after surgery (from an average of 8.2 to 3.1 at final follow-up). Postoperatively, the Oswestry Disability Index showed a significant reduction (14.7 on average). No slippage or signs of adjacent segment degeneration was detected in neuroimaging follow-up.

Conclusion 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.