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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