| Are there advantages in cervical intrafacetal fusion (cIFF) with minimal posterolateral fusion (PLF) compared to conventional PLF in posterior cervical fusion? |
Sunwoo Jang1 
, Sang Hyub Lee2
, Jeong Kyun Joo3
, Hong Kyung Shin1
, Jin Hoon Park1
, Sung Woo Roh1
, Sang Ryong Jeon1
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1Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
2Department of Neurosurgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju-Si, Gyeongsangnam-do, Republic of Korea
3St. Mary Central Madichuk Clinic, Goyang-si, Gyeonggi-do, Republic of Ko |
Corresponding Author:
Sang Ryong Jeon
Email: srjeon190@gmail.com
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Received: October 31, 2023 Revised: January 20, 2024 Accepted: January 25, 2024 |
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| Abstract |
Objective
We propose that cervical intrafacetal fusion (cIFF) using bone chip insertion into the facetal joint space additional to minimal PLF is a supplementary fusion method to conventional posterolateral fusion (PLF).
Methods
Patients who underwent posterior cervical fixation accompanied by cIFF with minimal PLF or conventional PLF for cervical myelopathy from 2012 to 2023 were investigated retrospectively. Radiological parameters including Cobb’s angles and C2-7 sagittal vertical axis (SVA) were compared between two groups. In cIFF with minimal PLF group, cIFF location and PLF location were carefully divided, and the fusion rates of each location were analyzed by CT scan.
Results
Among enrolled 46 patients, 31 patients were in cIFF group, 15 in PLF group. The postoperative change of Cobb’s angle in 1-year follow-up in cIFF with minimal PLF group and conventional PLF group were 0.1˚ ± 4.0 and -9.7˚ ± 8.4 respectively which was statistically lower in cIFF with minimal PLF group (p=0.022). Regarding the fusion rate in cIFF with minimal PLF group in postoperative 6 months, the rates was achieved in 267 facets (98.1%) in cIFF location, and 244 facets (89.7%) in PLF location (p<0.001).
Conclusion
Postoperative sagittal alignment was more preserved in cIFF with minimal PLF group compared with conventional PLF group. Additionally, in cIFF with minimal PLF group, the bone fusion rate of cIFF location was higher than PLF location. Considering the concerns of bone chip migration onto the spinal cord and relatively low fusion rate in PLF method, applying cIFF method using minimized PLF might be a beneficial alternative for posterior cervical decompression and fixation. |
| Keywords:
Intrafacetal fusion, Posterolateral fusion, Posterior cervical fusion |
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