Lumbar Facet Arthroplasty Versus Fusion for Grade-I Degenerative Spondylolisthesis with Stenosis

Video Abstract: Lumbar Facet Arthroplasty vs. Fusion

A video abstract is available with the new Level I study in JBJS by Nassr et al.: 

Lumbar Facet Arthroplasty Versus Fusion for Grade-I Degenerative Spondylolisthesis with Stenosis. A Prospective Randomized Controlled Trial 

This was a randomized, controlled, Food and Drug Administration Investigational Device Exemption trial. Included were patients with lumbar spinal stenosis and grade-I degenerative spondylolisthesis. Patients were randomized (2:1 ratio) to either decompression plus lumbar facet arthroplasty or decompression plus fusion.  

Access the video abstract here 

The primary outcome was a study-specific composite clinical success measure assessed at 24 months. A higher proportion of patients in the arthroplasty group than in the fusion group (73.5% vs. 25.5%; p < 0.001) achieved composite clinical success. The arthroplasty group had better improvement in most patient-reported outcome measures (PROMs). Surgical variables and complications did not differ significantly between the 2 groups, with the exception of a higher rate of developing symptomatic adjacent segment degeneration found in the fusion group. 

The researchers concluded that “decompression plus lumbar facet arthroplasty was associated with superior PROMs across multiple metrics, lower rates of new or progressive neurologic symptoms, and lower rates of symptomatic adjacent segment degeneration, equating to higher rates of composite clinical success, compared with decompression plus fusion, at 24 months postoperatively.” 

Read the full report by Nassr et al. at 

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