PDF(Pubmed)
Abstract：
UNASSIGNED: Lumbar articular fusion with the facet wedge (FW) technique is gaining increasing interest among surgeons for the treatment of vertebral instability due to its limited invasiveness and ease of use. Studies on cadavers have reported biomechanical properties similar to pedicle screws. Yet, the evidence supporting their use is still limited and moreover focused only on spinal degenerative disease.
UNASSIGNED: 96 cases of lumbar articular fusion with the FW techniques performed at 3 different centers between 2014 and 2022 were retrospectively analyzed based on the specific surgical indications: 1) degenerative spondylolisthesis/unstable lumbar stenosis; 2) synovial cysts; 3) adjacent segment disease (ASD). Medical records were reviewed to identify rates of complications and measures of functional outcome (ODI, low back pain VAS and modified Macnab scale) were collected both at baseline and at the follow-up visits. Wilcoxon signed-rank test was adopted to test for significant functional improvements.
UNASSIGNED: Significative clinical improvements were observed from baseline to follow-up regarding ODI and VAS scores. Overall rate of moderate and severe complications (according to Landriel-Ibañez scale) was 7.9%. Only 3.4% of patients with degenerative disease developed ASD requiring reoperations. Only one case of radicular deficit and one of device mobilization were reported. 2/4 cases of synovial cysts treated with unilateral fusions developed contralateral complications. 9 out of 16 (56.25%) patients who underwent long-term postoperative CT scans presented adequate degree of articular fusion.
UNASSIGNED: FW technique is easy, safe, and effective. Its low rate of complications justifies its use for cases of mild lumbar instability.
UNASSIGNED: 96 cases of lumbar articular fusion with the FW techniques performed at 3 different centers between 2014 and 2022 were retrospectively analyzed based on the specific surgical indications: 1) degenerative spondylolisthesis/unstable lumbar stenosis; 2) synovial cysts; 3) adjacent segment disease (ASD). Medical records were reviewed to identify rates of complications and measures of functional outcome (ODI, low back pain VAS and modified Macnab scale) were collected both at baseline and at the follow-up visits. Wilcoxon signed-rank test was adopted to test for significant functional improvements.
UNASSIGNED: Significative clinical improvements were observed from baseline to follow-up regarding ODI and VAS scores. Overall rate of moderate and severe complications (according to Landriel-Ibañez scale) was 7.9%. Only 3.4% of patients with degenerative disease developed ASD requiring reoperations. Only one case of radicular deficit and one of device mobilization were reported. 2/4 cases of synovial cysts treated with unilateral fusions developed contralateral complications. 9 out of 16 (56.25%) patients who underwent long-term postoperative CT scans presented adequate degree of articular fusion.
UNASSIGNED: FW technique is easy, safe, and effective. Its low rate of complications justifies its use for cases of mild lumbar instability.
摘要：
■具有小关节楔形（FW）技术的腰椎关节融合术由于其有限的侵入性和易用性，在外科医生中越来越受到治疗椎骨不稳定的兴趣。对尸体的研究报告了类似于椎弓根螺钉的生物力学特性。然而，支持其使用的证据仍然有限，而且仅集中在脊柱退行性疾病上。
■2014年至2022年在3个不同中心进行的FW技术腰椎关节融合术96例，回顾性分析其具体手术适应症：1）退行性腰椎滑脱/不稳定型腰椎管狭窄；2）滑膜囊肿；3）相邻节段疾病（ASD）。对医疗记录进行了审查，以确定并发症的发生率和功能结局的衡量标准(ODI，在基线和随访时收集腰痛VAS和改良的Macnab量表）。采用Wilcoxon符号秩检验来测试功能的显着改善。
■关于ODI和VAS评分从基线到随访观察到显著的临床改善。中度和重度并发症的总发生率（根据Landriel-Ibañez量表）为7.9％。只有3.4%的退行性疾病患者发生ASD，需要再次手术。仅报告了一例根性缺陷和一例设备动员。2/4例单侧融合治疗的滑膜囊肿发生对侧并发症。接受长期术后CT扫描的16例患者中有9例（56.25％）表现出足够的关节融合程度。
■FW技术很容易，安全,而且有效。其并发症发生率低，证明了其用于轻度腰椎不稳的情况。
■2014年至2022年在3个不同中心进行的FW技术腰椎关节融合术96例，回顾性分析其具体手术适应症：1）退行性腰椎滑脱/不稳定型腰椎管狭窄；2）滑膜囊肿；3）相邻节段疾病（ASD）。对医疗记录进行了审查，以确定并发症的发生率和功能结局的衡量标准(ODI，在基线和随访时收集腰痛VAS和改良的Macnab量表）。采用Wilcoxon符号秩检验来测试功能的显着改善。
■关于ODI和VAS评分从基线到随访观察到显著的临床改善。中度和重度并发症的总发生率（根据Landriel-Ibañez量表）为7.9％。只有3.4%的退行性疾病患者发生ASD，需要再次手术。仅报告了一例根性缺陷和一例设备动员。2/4例单侧融合治疗的滑膜囊肿发生对侧并发症。接受长期术后CT扫描的16例患者中有9例（56.25％）表现出足够的关节融合程度。
■FW技术很容易，安全,而且有效。其并发症发生率低，证明了其用于轻度腰椎不稳的情况。
