Skip to main content
Log in

The combined use of unilateral pedicle screw and contralateral facet joint screw fixation in transforaminal lumbar interbody fusion

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

This paper is to evaluate the efficacy and safety of transforaminal lumbar interbody fusion (TLIF) using unilateral pedicle screws along with contralateral translaminar facet joint screw (UPS+TFS) fixation in comparison with the method using bilateral pedicle screws fixation (BPS) in degenerative lumbar diseases.

Methods

Forty patients with single-level lumbar diseases were divided into two groups randomly. One group was treated by TLIF with BPS fixation while the other group was treated by the new technique with UPS+TFS fixation. The preoperative and postoperative ODI, JOA, VAPS scores, mean operation time, mean operation blood loss, fusion rate and complications were collected for comparison under two surgical methods. In terms of complications, only two cases of superficial infection in the BPS group and one case of urinary tract infection in the other group was found.

Results

The mean operation time and blood loss was significantly less in UPS+TFS group than in BPS group. The preoperation and postoperative ODI, JOA and VAPS at the intervals of 6 weeks, 3, 6 months and 1 year between the BPS and UPS+TFS group showed no significant disparities. Only one patient in UPS+TFS group was not fused with pseudoarthrosis formation.

Conclusions

The clinical efficacy and safety of TLIF with UPS+TFS fixation were comparable to BPS fixation; however, the soft tissue injury and the corresponding operation cost were reduced with unilateral pedicle screw plus translaminar facet screw fixation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Harms J, Rolinger H (1982) A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author’s transl). Z Orthop Ihre Grenzgeb 120:343–347

    Article  CAS  PubMed  Google Scholar 

  2. Magerl FP (1984) Stabilization of the lower thoracic and lumbar spine with external skeletal fixation. Clin Orthop 189:125–141

    PubMed  Google Scholar 

  3. Lauber S, Schulte TL, Liljenqvist U et al (2006) Clinical and radiologic 2–4-year results of transforaminal lumbar interbody fusion in degenerative and isthmic spondylolisthesis grades 1 and 2. Spine 31(1):1693–1698

    Article  PubMed  Google Scholar 

  4. Phillips FM, Cunningham B, Carandang G et al (2004) Effect of supplemental translaminar facet screw fixation on the stability of stand-alone anterior lumbar interbody fusion cages under physiologic compressive preloads. Spine 29(15):1731–1736

    Article  PubMed  Google Scholar 

  5. Best NM, Sasso RC (2006) Efficacy of translaminar facet screw fixation in circumferential interbody fusions as compared to pedicle screw fixation. J Spinal Disord Tech 19(2):98–103

    Article  PubMed  Google Scholar 

  6. Bjarke C, Stender H, Laursen M et al (2002) Long-term functional outcome of pedicle screw instrumentation as a support for posterolateral spinal fusion: randomized clinical study with a 5-year follow-up. Spine 27(12):1269–1277

    Article  Google Scholar 

  7. Fritzell P, Hagg O, Wessberg P et al (2002) Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish lumbar spine study group. Spine 27(11):1131–1141

    Article  PubMed  Google Scholar 

  8. Lonstein JE, Denis F, Perra JH et al (1999) Complications associated with pedicle screws. J Bone Joint Surg Am 81(11):1519–1528

    CAS  PubMed  Google Scholar 

  9. Esses SI, Sachs BL, Dreysin V (1993) Complications associated with the technique of pedicle screw fixation: a selected survey of ABS member. Spine 18(15):2231–2239

    Article  CAS  PubMed  Google Scholar 

  10. Jutte PC, Castelein RM (2002) Complications of pedicle screws in lumbar and lumbosacral fusions in 105 consecutive primary operations. Eur Spine J 11(6):594–598

    Article  CAS  PubMed  Google Scholar 

  11. Benini A, Magerl F (1993) Selective decompression and translaminar articular facet screw fixation for lumbar canal stenosis and disc protrusion. Br J Neurosurg 7(4):413–418

    Article  CAS  PubMed  Google Scholar 

  12. Kim SM, Lim TJ, Paterno J et al (2004) A biomechanical comparison of supplementary posterior translaminar facet and transfacetopedicular screw fixation after anterior lumbar interbody fusion. J Neurosurg Spine 1(1):101–107

    Article  PubMed  Google Scholar 

  13. Sethi A, Muzumdar AM, Ingalhalikar A et al (2011) Biomechanical analysis of a novel posterior construct in a transforaminal lumbar interbody fusion model an in vitro study. Spine J 11(9):863–869

    Article  PubMed  Google Scholar 

  14. Kandziora F, Schleicher P, Scholz M et al (2005) Biomechanical testing of the lumbar facet interference screw. Spine 30(2):E34–E39

    Article  PubMed  Google Scholar 

  15. Schleicher P, Beth P, Ottenbacher A et al (2008) Biomechanical evaluation of different asymmetrical posterior stabilization methods for minimally invasive transforaminal lumbar interbody fusion. J Neurosurg Spine 9(4):363–371

    Article  PubMed  Google Scholar 

  16. Montesano PX, Magerl F, Jacobs RR et al (1988) Translaminar facet joint screws. Orthopedics 11(10):1393–1397

    CAS  PubMed  Google Scholar 

  17. Jacobs RR, Montesano PX, Jackson RP (1989) Enhancement of lumbar spine fusion by the use of translaminar facet joint screw. Spine 14(1):12–15

    Article  CAS  PubMed  Google Scholar 

  18. Heggeness MH, Esses SI (1991) Translaminar facet joint screw fixation for lumbar and lumbosacral fusion. A clinical and biomechanical study. Spine 16 (6Suppl):S266–S269

    Google Scholar 

  19. Jang JS, Lee SH (2005) Minimally invasive transforaminal lumbar interbody fusion with ipsilateral pedicle screw and contralateral facet screw fixation. J Neurosurg Spine 3(3):218–223

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Xiaoxing Jiang or Zhenzhou Feng.

Ethics declarations

Conflict of interest

There is no actual or potential conflict of interest in relation to this article.

Additional information

Y. Cao and Z. Chen contributed equally to this work as co-first authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cao, Y., Chen, Z., Jiang, C. et al. The combined use of unilateral pedicle screw and contralateral facet joint screw fixation in transforaminal lumbar interbody fusion. Eur Spine J 24, 2607–2613 (2015). https://doi.org/10.1007/s00586-015-4120-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-015-4120-x

Keywords

Navigation