Good 5-year postoperative outcomes after facet fusion using a percutaneous pedicle screw system for degenerative lumbar spondylolisthesis.

ABSTRACT

Many authors have reported no significant differences in clinical outcomes between posterolateral fusion (PLF) and interbody fusion, as well as satisfactory long-term outcomes after PLF. Facet fusion (FF), a minimally invasive evolution of PLF, has also resulted in good clinical outcomes. This study aimed to assess the clinical outcomes 5 years after FF for degenerative lumbar spondylolisthesis (DLS) and determine whether good clinical outcomes were maintained after FF. Records of 115 patients who underwent FF for single-level DLS with at least 5 years of follow-up were retrospectively studied. The therapeutic effectiveness of FF was assessed as a clinical outcome using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), the Roland-Morris Disability Questionnaire (RMDQ), and the visual analogue scale (VAS) preoperatively and at 1 and 5 years postoperatively. Computed tomography was performed for fusion confirmation. The revision surgery rate was also evaluated. The JOABPEQ category scores demonstrated therapeutic effectiveness in 81.7% of patients at 1 year postoperatively and 81.4% of patients at 5 years postoperatively for low back pain; the corresponding proportions for walking ability were 93.8% and 86.6%, respectively. There were no significant differences in therapeutic effectiveness at 1 and 5 years postoperatively for any category, including the RMDQ and VAS scores. The fusion rate was 90.4% at the final follow-up. Four patients required revision surgery for adjacent segment disease 1-5 years after the first surgery (revision surgery rate, 3.5%). Good clinical outcomes were maintained 5 years after FF, and FF had an extremely low revision surgery rate.