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Minimally Invasive Facet Screw Fixation

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Minimally Invasive Spine Surgery

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Abstract

Facet screw fixation is a relatively simple and effective technique for short-segment fusion in the spine. By placing screws directly across the articulating facet joint to immobilize a motion segment, one reduces the surgical exposure and hardware use compared to contemporary pedicle screw fixation. Other advantages include a shorter operating time, low cost, low complication rate, and potentially quicker postoperative recovery compared to pedicle screw fixation. Biomechanical and clinical studies have proven that overall facet screw fixation is a safe and stable method of posterior stabilization with high fusion rate if it is used properly for the right indication. In this chapter, we discuss the indications, contraindications, surgical technique, and clinical results of this technique.

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Author information

Authors and Affiliations

  1. Texas Back Institute, Plano, TX, USA

    Anthony E. Bozzio

  2. Texas Back Institute, Texas Health Presbyterian Hospital Plano, Scoliosis and Spine Tumor Center, Plano, TX, USA

    Xiaobang Hu & Isador H. Lieberman

Authors
  1. Anthony E. Bozzio
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  2. Xiaobang Hu
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  3. Isador H. Lieberman
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Corresponding author

Correspondence to Isador H. Lieberman .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Frank M. Phillips

  2. Texas Back Institute Texas Health Presbyterian Hospital Plano Scoliosis and Spine Tumor Center, Plano, TX, USA

    Isador H. Lieberman

  3. Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA

    David W. Polly Jr.

  4. Department of Neurological Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA

    Michael Y. Wang

Appendices

Quiz Questions

  1. 1.

    Minimally invasive translaminar and direct facet screw fixation is a cost-effective, safe, and efficient procedure for the segmental stabilization of the lumbar and lumbosacral spine.

    1. (a)

      True

    2. (b)

      False

  2. 2.

    Regarding facet screw fixation

    1. (a)

      It is biomechanically similar to pedicle screw fixation when treating a spondylolysis.

    2. (b)

      King described direct transfacet fixation as early as 1948.

    3. (c)

      Boucher in 1959 modified the trajectory with further fixation into the pedicle of the cephalad segment.

    4. (d)

      Magerl in 1984 extended the concept of transfacet fixation using a coronal plane trajectory with fixation in the pars.

    5. (e)

      Facet screw fixation can only be executed in an open fashion.

  3. 3.

    The contraindications to translaminar screw fixation include

    1. (a)

      Stable anterior column

    2. (b)

      A balanced spine with no deformities, such as scoliosis and kyphosis

    3. (c)

      Osteopenia

    4. (d)

      Patients who will not require an extensive decompression

    5. (e)

      Deficient posterior elements (lamina, facets, and/or spinous process)

Answers

  1. 1.

    a

  2. 2.

    b

  3. 3.

    e

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Bozzio, A.E., Hu, X., Lieberman, I.H. (2019). Minimally Invasive Facet Screw Fixation. In: Phillips, F., Lieberman, I., Polly Jr., D., Wang, M. (eds) Minimally Invasive Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-19007-1_21

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  • DOI: https://doi.org/10.1007/978-3-030-19007-1_21

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19006-4

  • Online ISBN: 978-3-030-19007-1

  • eBook Packages: MedicineMedicine (R0)

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