Facet fusion in the lumbosacral spine: A 2-year follow-up study

OBJECTIVE: A clinical and radiological follow-up study was undertaken to assess the safety, efficacy, and complication rate associated with instrumented facet fusion of the lumbar and lumbosacral spine. METHODS: This study involved 99 patients with degenerative lumbar disorders who were treated surgically at the authors' neurosurgical department and followed for more than 2 years. Eighty-two patients underwent one-level fusion for the treatment of Grade I or II degenerative spondylolisthesis and accompanying spinal canal stenosis (44 patients) or recurrent disc herniation (38 patients). Seventeen patients underwent two-level fusion for the treatment of either double instances of the above indications (seven patients) or concurrent stenosis at the adjacent level (10 patients). RESULTS: There were no technique-related complications. The overall 2-year success rate of fusion was 96%; the success rates by fusion type were 99% in one-level fusions and 88% in two-level fusions. Degenerative spondylolisthesis had the highest success rate at 100%, whereas the success rate in patients who had not responded to previous discectomy was 93%. Patients with concurrent stenosis experienced the lowest success rate: 80%. Excellent or good clinical results were obtained for 85% of patients with one-level fusions and for 65% of patients with two-level fusions. CONCLUSION: Instrumented facet fusion alone is a simple, safe, and effective surgical option for the treatment of patients with single-level disorders, especially patients with degenerative spondylolisthesis.