From a biomechanical point of view, facet screw fixation seems to provide equal stiffness during flexion-extension movements and lesser stiffness in axial rotation and lateral bending compared with pedicle screw fixation. However, the addition of the central cross-link in the Facet-Link System should theoretically increase the resistance to axial torque and ensure similar biomechanical features of the pedicle screw systems.
Trungu et al., from Rome and, Tricase, Italy reported a total of 25 patients between May 2015 and June 2016 affected by radiologically demonstrated one-level Lumbar spinal stenosis (LSS) with facet joint degeneration and grade I spondylolisthesis in a prospective study. All the patients underwent laminectomy, foraminotomy, and one-level facet fixation (Facet-Link, Inc., Rockaway, New Jersey, United States). Pre- and postoperative clinical (Oswestry Disability Index [ODI], Short Form 36 [SF-36]) and radiologic (radiographs, magnetic resonance imaging, computed tomography) data were collected and analyzed.
Mean follow-up was 12 months. The L4-L5 level was involved in 18 patients (72%) and L5-S1 in 7 patients (28%); the average operative time was 80 minutes (range: 65-148 minutes), and the mean blood loss was 160 mL (range: 90-200 mL). ODI and SF-36 showed a statistically significant (p < 0.05) improvement at last follow-up.