Facet joint fusion by thermal ablation for single-level lumbar spinal stenosis

Abstract Previous studies demonstrated the presence of bridging bone across the facet joints in postoperative computed tomography (CT) scans of patients who underwent unsuccessful posterior lumbar fusion (PLF) and interbody fusion (IBF) procedures. Recent research shows that facet joint fusion achieved through bone grafting with pedicle screw instrumentation leads to satisfactory clinical outcomes and fusion rates. Building upon these findings, there is a hypothesis that facet joint fusion achieved solely through thermal ablation, without the need for bone grafting, may yield credible fusion rates and clinical outcomes. A retrospective review was conducted on 136 patients who underwent lumbar fusion utilizing thermal ablation of the facet joint. CT and clinical outcomes, including Visual Analog Scale (VAS), Japanese Orthopaedic Association (JOA), and Oswestry Disability Index (ODI), were evaluated both preoperatively and at the 6-month, 1-year, and 2-year follow-up intervals. At the final assessment, 90.4% of patients achieved excellent or good results, and no technique-related complications were observed in any of the patients. We believe that the compelling clinical outcomes and fusion rates achieved through thermal ablation of the facet joint highlight its potential as a highly feasible alternative method for treating single-level lumbar spinal stenosis, which potentially replaces traditional interbody fusion (IBF) techniques.