A comparative cadaveric biomechanical study of bilateral FacetFuse

Background

Achieving optimal immediate stability is crucial in lumbar fusion surgeries. Traditionally, four pedicle screws have been utilized to provide posterior stability at the L5-S1 level. However, the use of bilateral transfacet pedicle screws (TFPS) as an alternative construct has shown promising results in terms of biomechanical stability. This research paper investigates the biomechanical stability of TFPS with a lag design in comparison to equivalent-sized unilateral or bilateral fully threaded pedicle screw-rod (PSR) constructs at the L5-S1 disc level. The study assesses the immediate stability achieved by these constructs which have clinical implications in achieving lumbar segment fusion. We hypothesized that bilateral TFPS will yield immediate lumbar fixation that is comparable to unilateral or bilateral PSR constructs.

Methods

Cadaveric biomechanical testing was conducted

Results

Fourteen specimens were analyzed with an average age of 53.14±10.99 years and comparable bone mineral density. TFPS demonstrated a reduced ROM that was notably lower than that of unilateral PSR in all loading modes and was comparable to bilateral PSR, especially in extension and axial rotation (AR). The unilateral and bilateral PSR groups differed notably in lateral bending (LB) and AR.

Conclusions

Bilateral TFPS demonstrated superior immediate stability than unilateral PSR and was an equivalent substitute to bilateral PSR constructs at the L5-S1 disc level. Further clinical investigations are necessary to validate these results and ascertain the long-term outcomes and advantages associated with the use of bilateral TFPS as an alternative construct. Our findings showed that bilateral TFPS could potentially reduce the number of required pedicle screws while achieving comparable stability in lumbar fusion procedures.

Informations de copyright

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Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jss.amegroups.com/article/view/10.21037/jss-24-10/coif). K.R.C. reports that he is the cofounder and CEO of KIC (Kingsley Investment Company) Ventures and has ownership shares in the company. V.L. is an employee of LESSpine, a for-profit medical device company. The other authors have no conflicts of interest to declare.