J Neurol Surg A Cent Eur Neurosurg 2021; 82(01): 034-042
DOI: 10.1055/s-0040-1716534
Original Article

Facet Joint Replacement: Intermediate- and Long-Term Outcome in a Large Case Series

1   Department of Neurosurgery, Johannes Wesling Hospital, Ruhr-University Bochum, Minden, Germany
David Reinecke
1   Department of Neurosurgery, Johannes Wesling Hospital, Ruhr-University Bochum, Minden, Germany
Michael Flörke
1   Department of Neurosurgery, Johannes Wesling Hospital, Ruhr-University Bochum, Minden, Germany
Peter Horn
2   Department of Neurosurgery, Helios Dr. Horst Schmidt Hospital, Wiesbaden, Germany
Robert Schönmayr
2   Department of Neurosurgery, Helios Dr. Horst Schmidt Hospital, Wiesbaden, Germany
› Author Affiliations
Funding The implementation of the study was sponsored by Globus Medical (€6.800). The sponsor had no influence on design, implementation, or results and interpretation of the study.


Background The long-term outcome of facet joint replacement (FJR) still is to be proven.

Methods We present a prospective case series of 26 (male-to-female ratio of 1:1; mean age: 61 years) patients undergoing FJR with a follow-up of at least 1 year (range: 12–112; mean: 67 months). Visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and the 12-Item Short Form Health Survey (SF-12) were applied pre- and postoperatively (after 3, 6, and 12 months) as well as at the last follow-up (N = 24). Using X-rays of the lumbar spine (N = 20), the range of motion (ROM) and disk height in the indicator and adjacent levels were assessed.

Results FJR was performed at L3/L4 (N = 7), L4/L5 (N = 17), and L5/S1 (N = 2). Mean VAS (mm) for back pain decreased from 71 to 18, mean VAS for right leg pain from 61 to 7, and from 51 to 3 for the left leg. Mean ODI dropped from 51 to 22% (for all p < 0.01). Eighty seven percent of patients were satisfied and pretreatment activities were completely regained in 78.3% of patients. Disk height at the indicator and adjacent levels and ROM at the indicator segment and the entire lumbar spine were preserved. No loosening of implants was observed. Explantation of FJR and subsequent fusion had to be performed in four cases (15.4%).

Conclusions In selected cases, long-term results of FJR show good outcome concerning pain, quality of life, preservation of lumbar spine motion, and protection of adjacent level.


The study was approved by the local ethics committee of the Ruhr-University Bochum, Bad Oeynhausen, Germany (AZ 2017–156).

Supplementary Material

Publication History

Received: 18 February 2020

Accepted: 22 April 2020

Article published online:
05 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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