Instrumented facet fusion for the degenerative lumbar disorders

A new, simple, minimally morbid procedure used to treat degenerative lumbar spinal disorders is described. The authors based their treatment on the McBride technique of facet fusion, which was modified and supplemented with pedicle screw fixation. The first 32 consecutive patients with degenerative spondylolisthesis and failed back surgery syndrome were treated, and followed for more than a year. Surgically, 26 patients had a single level fusion, and 6 patients had a two level fusion. Postoperative radiographs and computed tomography (CT) scans were evaluated to determine the fusion status. There were no specific complications related with the facet fusion. Thirty of 32 (93.8%) had solid fusions according to the computed tomographic criteria. Two patients showed a questionable union on CT scan but motion was less than 5 degrees on dynamic films. While 96.2% (25/26) of patients with a single level procedure had solid fusion, rate of union in the patients with two level procedures was 83.3% (5/6). This preliminary study of 32 patients shows that instrumented facet fusion appears to be a safe and effective procedure for lumbar spine fusions, demonstrating a high fusion rate with rarely serious complications.