Experience of using only transfacetal screws for cervical and lumbar spinal stabilization without decompression for degenerative spine disease

Aim: The authors report experience with 14 cases where two transfacet screws were used for transfacetal fixation of each joint for stabilization of the lumbar spinal segment and one transfacet screw was used for transfacetal fixation of each joint for stabilization of the cervical spinal segment. The anatomical subtleties of the technique of insertion of screws are elaborated. Materials and Methods: During the period from July 2024 to October 2024, 14 patients having spinal segmental vertical instability related to lumbar canal stenosis were treated in Helmya Military Hospital by insertion of screws into each articular assembly by transfacetal technique. We positioned the patient, then made a wide surgical exposure, and inserted the screws in an appropriate angulation. Results: During the period of follow-up, all treated patients had high patients’ satisfaction rate with relief of symptoms, and spinal levels showed firm bone fusion. There was no complication related to the insertion of the screws. There was no incidence of screw misplacement or implant rejection. Conclusions: Screw insertion into the firm and largely cortical bones of facets of the lumbar spine can provide robust fixation and firm stabilization of the spinal segment. The large size of the facets provides an opportunity to insert screws at each spinal segment. The firm and cortical bone material and absence of any neural or vascular structure in the course of the screw traverse provide strength and safety to the process.