Risk Factor Analysis of Facet Fusion Following Cervical Lateral Mass Screw Fixation with a Minimum 1-Year Follow-up: Assessment of Maximal Insertional Screw Torque and Incidence of Loosening.

Neurologia Medico-chirurgica
Ryo KanematsuFumiaki Honda

Abstract

Posterior stabilization is a common surgical procedure, which aims for rigid stabilization by facet fusion. Facet non-union has a potential risk of the screw loosening and malalignment. Although some authors have reported the influencing factors about screw loosening in the lumbar spine, there are few reports about the risk factor contributing to the facet non-union in the cervical spine. In all, 22 patients (78 facets and 122 screws) with degenerative cervical kyphosis or spondylolisthesis who underwent decompression and lateral mass screw (LMS) fixation were analyzed. Age, gender, smoking, bone mineral density (BMD), the degree of facet decortication with bone packing, and screw loosening were investigated as risk factors contributing to the facet non-union at each segmental fused level. Facet fusion rate was 85.9% (67/78 facets) and the incidence of loosening was 4.9% (6/122 screws, 4 patients). Insufficient facet decortication with bone packing is a significant risk factor of facet non-union (p <0.05, odds ratio: 26.5). All six loosened screws were associated with bony non-union of the facet and were located in the uppermost or lowermost vertebrae. Comparing loosened screws and stable screws, the average maximal insertional...Continue Reading

References

Sep 1, 1996·The Journal of Bone and Joint Surgery. American Volume·J G HellerA Diop
May 24, 2000·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·F B ChristensenC Bünger
Nov 16, 2004·The Spine Journal : Official Journal of the North American Spine Society·Alan S Hilibrand, Matthew Robbins
Apr 9, 2005·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Tomoyuki OzawaHideshige Moriya
Apr 9, 2005·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Koichi MizunoKazuyuki Otani
Aug 4, 2012·American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics·Antonio GraccoGiuseppe Siciliani
Jan 27, 2015·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Fabio GalbuseraHans-Joachim Wilke
Jun 9, 2019·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Keitaro MatsukawaKazuhiro Chiba

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