Abstract
Roentgen stereophotogrammetric analysis (RSA) was used to assess whether there is a potential for biodegradable rods crossing the denuded facet joints to increase the stability and healing rate of lumbar posterolateral fusions. Eleven consecutive patients with lumbosacral disc/facet joint degeneration had a posterolateral fusion augmented with 2- or 3.2-mm biodegradable rods passing perpendicularly through the center of the denuded facet joints. The patients were followed-up with RSA in supine and erect positions monthly from the 2nd to the 6th postoperative month, and again 1 year postoperatively. All seven L5-S 1 fusions healed. Four cases were stable as defined by RSA within 3 months, two within 6 months, and one within 1 year. One L4-S1 fusion could not be evaluated by RSA. None of the remaining three L4-S1 fusions fully healed. In all three cases 1- to 3-mm intervertebral translations remained at 1 year. None of the 11 fusions showed any radiographic signs of osteolysis around the biodegradable rods. The promising results of this pilot study indicate that posterolateral L5-S 1 fusion augmented with transarticular biodegradable rods crossing the denuded facet joints may yield rapid intervertebral stabilization and a high healing rate without any adverse rod effects. This may be due to enhanced initial fusion stabilization and/or increased ossification induced by the rods.
Similar content being viewed by others
References
Axelsson P, Johnsson R, Strbmqvist B, Arvidsson M, Herrlin K (1994) Posterolateral lumbar fusion. Outcome of 71 consecutive operations after 4 (2–7) years. Acta Orthop Scand 65:309–314
Böstman OM (1991) Current concepts review. Absorbable implants for the fixation of fractures. J Bone Joint Surg [Am] 73:148–153
Brodsky AE, Kovalsky ES, Khalil MA (1991) Correlation of radiologic assessment of lumbar spine fusions with surgical exploration. Spine 16: S261-S265
Dawson EG, Lotysch M, Urist MR (1981) Intertransverse process lumbar arthrodesis with autogenous bone graft. Clin Orthop 154:90–96
Grubb SA, Lipscomb HJ (1992) Results of lumbosacral fusion for degenerative disc disease with and without instrumentation. Two-to-five-year follow-up. Spine 17:349–355
Johnsson R (1993) The use of orthoses in lumbar spine fusion. Acta Orthop Scand 64 [Suppl 251]: 92–93
Johnsson R, Selvik G, Strömgvist B, Sundén G (1990) Mobility of the lower lumbar spine after posterolateral fusion determined by roentgen stereophotogrammetric analysis. Spine 15:347–350
Johnsson R, Strömgvist B, Axelsson P, Selvik G (1992) Influence of spinal immobilization on consolidation of posterolateral lumbosacral fusion. A roentgen stereophotogrammetric and radiographic analysis. Spine 17:16–21
Mardjetko SM, Connolly PJ, Shott S (1994) Degenerative lumbar spondylolisthesis. A meta-analysis of literature 1979–1993. Spine 19: S2256-S2265
Selvik G (1989) Roentgen stereophotogrammetry. A method for the study of the kinematics of the skeletal system, 2nd edn. Acta Orthop Scand 60 [Suppl 232]:1–51
Strauss PJ, Novotny JE, Wilder DG, Grobler LJ, Pope MH (1994) Multidirectional stability of the Graf system. Spine 19:965–972
Strömqvist B (1993) Posterolateral uninstrumented fusion. Acta Orthop Scand 64 [Suppl 251]: 97–99
Wood GW, Boyd RJ, Carothers TA, Mansfield FL, Rechtine GR, Rozen MJ, Sutterlin CE (1995) The effect of pedicle screw/plate fixation on lumbar/lumbosacral autogenous bone graft fusions in patients with degenerative disc disease. Spine 20: 819–830
Zdeblick TA (1993) A prospective, randomized study of lumbar fusion. Preliminary results. Spine 18:983–991
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Johnsson, R., Axelsson, P. & Strömgvist, B. Posterolateral lumbar fusion using facet joint fixation with biodegradable rods: A pilot study. Eur Spine J 6, 144–148 (1997). https://doi.org/10.1007/BF01358748
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01358748