The spine journal : official journal of the North American Spine Society
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Radiologic evidence of successful lumbar fusion has traditionally been based on bridging bone spanning the intertransverse processes (posterolateral fusion or PLF) or disc space (interbody fusion, or IBF). Often, postoperative computed tomography (CT) of unsuccessful PLF and IBF demonstrates bridging bone across the facet joints or connecting the medial transverse process to the ipsilateral superior articular facet of the caudal vertebra. The significance of this finding in terms of implant stability and clinical outcomes has not previously been reported. ⋯ FJF/PMF is often observed on postoperative CT evaluation following surgery originally performed to achieve PLF or IBF. Short-term follow-up suggests no significant difference in implant loosening rates or patient reported outcomes when FJF/PMF is observed versus PLF or IBF in such patients. Long-term clinical outcomes of FJF/PMF versus PLF or IBF remain unknown. These findings apply solely to single-level instrumented spinal fusion surgery utilizing pedicle screws with or without IBF.