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Outcomes of posterior facet versus pedicle screw fixation of circumferential fusion: a cohort study

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Abstract

Purpose

To compare single-level circumferential spinal fusion using pedicle (n = 27) versus low-profile minimally invasive facet screw (n = 35) posterior instrumentation.

Method

A prospective two-arm cohort study with 5-year outcomes as follow-up was conducted. Assessment included back and leg pain, pain drawing, Oswestry disability index (ODI), pain medication usage, self-assessment of procedure success, and >1-year postoperative lumbar magnetic resonance imaging.

Results

Significantly less operative time, estimated blood loss and costs were incurred for the facet group. Clinical improvement was significant for both groups (p < 0.01 for all outcomes scales). Outcomes were significantly better for back pain and ODI for the facet relative to the pedicle group at follow-up periods >1 year (p < 0.05). Postoperative magnetic resonance imaging found that 20 % had progressive adjacent disc degeneration, and posterior muscle changes tended to be greater for the pedicle screw group.

Conclusion

One-level circumferential spinal fusion using facet screws proved superior to pedicle screw instrumentation.

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Acknowledgments

Funded by Midwest Spine Institute Research Division and Abbott Spine.

Conflict of interest

None.

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Authors and Affiliations

  1. Midwest Spine Institute, 1950 Curve Crest Blvd, Stillwater, MN, 55082, USA

    Glenn R. Buttermann

  2. Center for Diagnostic Imaging, Minneapolis, MN, USA

    William J. Mullin

  3. University of Utah, Salt Lake City, Utah, USA

    Tague M. Thorson

Authors
  1. Glenn R. Buttermann
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  2. Tague M. Thorson
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  3. William J. Mullin
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Correspondence to Glenn R. Buttermann.

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Buttermann, G.R., Thorson, T.M. & Mullin, W.J. Outcomes of posterior facet versus pedicle screw fixation of circumferential fusion: a cohort study. Eur Spine J 23, 347–355 (2014). https://doi.org/10.1007/s00586-013-2999-7

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  • DOI: https://doi.org/10.1007/s00586-013-2999-7

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