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Facet Wedge Fixation in Lumbar Spine Degenerative Pathology: A New Option for Minimally-Invasive Posterior Approach?

Alessandro Landi*, Benedetta Fazzolari, Nicola Marotta and Roberto Delfini

In recent years spinal surgery has undergone a drastic change of course, mainly due to the increasing use of minimally invasive and percutaneous techniques for the treatment of lumbar spine degenerative pathology. This has led to the development of techniques more effective (for the pathology) and less invasive (for the patient). Recently the technological progress focused on a very specific vertebral fusion technique: the facet joint fixation. This technique has already been described in past as available with the assistance of autologous bone chips into the facet joint; nowadays it has been brought up to date by the development and use of an implantable device that promotes the bone fusion of the joint complex: the Facet-Wedge®. The employment of this device seems to offer a minimally invasive choice to the standard posterior screws fixation techniques for the treatment of selected cases of lumbar degenerative pathologies. Obviously their application has to be evaluated on the basis of a careful preoperative radiological planning. Up to date there aren’t in literature clinical trials about the effective of this device and this technique. The biomechanical meaning of this device, the possibility of implanting in percutaneous technique and in combined instrumentation with anterior cages or different posterior techniques, could reveal that this technique might be an effective and feasible alternative, which needs to be addressed in further studies.