Simple facet joint repair with dynamic pedicular system: technical note and case series

Abstract

Purpose: Facet joints are important anatomical structures for the stability of spine. Surgical or degenerative damage to a facet joint may lead to spinal instability and causes clinical problems. This article explains the importance of facet joints, reviews facet replacement systems, and describes a simple and effective method for facet replacement after surgical removal of facet joints. Materials and Methods: Ten patients were operated with the diagnosis of unilateral nerve root compression secondary to facet degeneration. The hypertrophic facet joints were removed with microsurgical techniques and the roots were decompressed. Then, a unilateral artificial facet joint was created using two hinged screws and a dynamic rod. Results: The clinical outcome of all the patients was determined good or excellent at second and last follow-up (mean 13.3 months) controls using visual analog scale (VAS) and Oswestry Disability Index (ODI) scores. Radiological evaluations also demonstrated no implant-related complications. Conclusions: The authors suggest that, if removal of a facet joint is necessary to decompress the nerve roots, the joint can be replaced by a construct composed of two hinged screws connected by a dynamic rod. This simple system mimics the function of a normal facet joint and is an effective technique for unilateral facet joint replacement.