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European Spine Journal

, Volume 23, Issue 2, pp 347–355 | Cite as

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

  • Glenn R. ButtermannEmail author
  • Tague M. Thorson
  • William J. Mullin
Original Article

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.

Keywords

Facet screw Fusion Lumbar Minimally invasive Outcomes Pedicle screw 

Notes

Acknowledgments

Funded by Midwest Spine Institute Research Division and Abbott Spine.

Conflict of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Glenn R. Buttermann
    • 1
    Email author
  • Tague M. Thorson
    • 3
  • William J. Mullin
    • 2
  1. 1.Midwest Spine InstituteStillwaterUSA
  2. 2.Center for Diagnostic ImagingMinneapolisUSA
  3. 3.University of UtahSalt Lake CityUSA

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