• Glenn R Buttermann, Tague M Thorson, and William J Mullin.
• Midwest Spine Institute, 1950 Curve Crest Blvd, Stillwater, MN, 55082, USA, butte011@umn.edu.
• Eur Spine J. 2014 Feb 1; 23 (2): 347-55.

PurposeTo compare single-level circumferential spinal fusion using pedicle (n = 27) versus low-profile minimally invasive facet screw (n = 35) posterior instrumentation.MethodA prospective two-arm cohort study with 5-year outcomes as follow-up was conducted. Assessment included back and leg pain, pain drawing, Oswestry disability index (ODI), pain medication usage, self-assessment of procedure success, and >1-year postoperative lumbar magnetic resonance imaging.ResultsSignificantly less operative time, estimated blood loss and costs were incurred for the facet group. Clinical improvement was significant for both groups (p < 0.01 for all outcomes scales). Outcomes were significantly better for back pain and ODI for the facet relative to the pedicle group at follow-up periods >1 year (p < 0.05). Postoperative magnetic resonance imaging found that 20 % had progressive adjacent disc degeneration, and posterior muscle changes tended to be greater for the pedicle screw group.ConclusionOne-level circumferential spinal fusion using facet screws proved superior to pedicle screw instrumentation.

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