Facet fixation: an alternative to minimally-invasive posterior lumbar stabilization?

Abstract

The study objective is to analyze literature and evaluate based on the obtained data the effectiveness of decompression of neural structures using different methods of facet fixation.Materials and methods. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following inclusion criteria were used: full-text article in English, patient age above 19 years, presence of evaluation of the results of facet fixation, degenerative disease of the lumbar spine in patients.Results. First search in the PubMed database returned 198 results. Among them, 38 articles complied with the inclusion criteria, and 33 articles didn’t contain full data on patient outcomes in the context of the studied stabilization methods. The selected 5 articles contained data on treatment results, rates of fixation and complications. Many authors note good clinical effect and decreased rate of intra- and postoperative complications for facet fixation compared to transpedicular fixation.Study limitations. Absence of systematic reviews and availability of only 1 article for each method of facet fixation. Small patient samples and short follow-up.Conclusion. Decompression and facet fixation in a single spinal motion segment in combination with posterior lumbar, transforaminal and lateral lumbar interbody fixation including use of minimally invasive technologies and other methods in many cases allows to achieve good clinical effect and firm stabilization.