Prevalence and treatment of facet syndrome in patients with lumbar spinal stenosis managed with posterior lumbar vertebral spinal stabilization FFX® facet cages.

Background: Facet joint degeneration represents a common source of low back pain and contributes to the development of lumbar spinal stenosis (LSS). We sought to identify the prevalence of facet syndrome in patients with LSS planned to undergo decompression and placement of facet cages (FFX^® device, SC Medica) and the relationship of medial branch block (MBB) test results with postoperative visual analog scale (VAS) pain scores.

Materials and methods: LSS patients undergoing decompression and placement of facet cages performed for a period of 1 year were included. Patients who did not undergo an MBB test prior to surgery were excluded.

Results: A total of 22 patients met the inclusion criteria for the study. The mean age was 69.4 ± 12.9 years with a majority of patients (63.6%) being female. Sixteen of the 22 (73%) patients had a positive MBB test. VAS scores were similar at baseline between the MBB positive and negative subgroups. The improvement in postoperative VAS back scores compared to baseline was greater for patients with a positive block test compared to those with a negative test (-4.7 vs. -1.8, respectively). As expected with the decompression part of the procedure, the improvement of VAS leg scores was similar for patients with positive and negative block tests compared to baseline.

Conclusion: The present study documents the high prevalence of facet syndrome in patients with LSS and the clinical benefits associated with the use of facet fusion cages to reduce facet-generated back pain.