Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc space

Introduction: Cervical stenosis may be treated surgically with anterior or posterior decompression with or without fixation. Recently, facet fusion using implantable devices using a posterior approach has been described as an alternative to anterior cervical discectomy and fusion (ACDF). To our know...

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Main Authors: Christopher Seidel, Clifford Pierre, Luke Jouppi, Luke DiPasquale, Chelsea Bush, Anna Anderson, Amit R. Patel
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:World Neurosurgery: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S259013972500047X
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author Christopher Seidel
Clifford Pierre
Luke Jouppi
Luke DiPasquale
Chelsea Bush
Anna Anderson
Amit R. Patel
author_facet Christopher Seidel
Clifford Pierre
Luke Jouppi
Luke DiPasquale
Chelsea Bush
Anna Anderson
Amit R. Patel
author_sort Christopher Seidel
collection DOAJ
description Introduction: Cervical stenosis may be treated surgically with anterior or posterior decompression with or without fixation. Recently, facet fusion using implantable devices using a posterior approach has been described as an alternative to anterior cervical discectomy and fusion (ACDF). To our knowledge, no anatomic studies have compared the surface area of the cervical facet joints to the intervertebral space. This study sought to provide a better understanding of the potential surface areas for arthrodesis. Methods: We performed a cross-sectional retrospective review using CT scans of the cervical spine in patients who had undergone imaging between 2014 and 2017. Using our institution's imaging software, we measured the area contained within the intervertebral space and the facet joints bilaterally. All surface area values for each intervertebral space were then compared using a paired t-test to the cumulative surface area of the facet joints calculated at each level. Results: Two hundred twelve patients (120 male, 92 female) were eligible for the analysis based on the inclusion and exclusion criteria. The mean age was 33 ± 6.0 years (range 18–55). The mean BMI was 29 ± 7.2 (range 19–58). In each of the comparisons, the combined intra-facet joint surface area (IFSA) was significantly greater than the intervertebral surface area (IVSA) of the corresponding interbody space. Conclusion: The surface area between the combined facet joints was almost two times greater than the intervertebral space. This may help establish an anatomic basis for comparable fusion results between the traditional ACDF and posterior fusion.
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spelling doaj-art-d4ba63b4b8e448acadaa919ebe68fa792025-08-20T03:24:59ZengElsevierWorld Neurosurgery: X2590-13972025-07-012710047310.1016/j.wnsx.2025.100473Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc spaceChristopher Seidel0Clifford Pierre1Luke Jouppi2Luke DiPasquale3Chelsea Bush4Anna Anderson5Amit R. Patel6WellSpan Health, 1001 S. George St. PO Box 15198, York, 17405-7198, PASeattle Science Foundation, Seattle, WA, 98122, USA; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, 98122, USASeattle Science Foundation, Seattle, WA, 98122, USA; Swedish Neuroscience Institute, Swedish Medical Center, Seattle, WA, 98122, USA; Corresponding author. Swedish Neuroscience Institute, 550 17th Avenue, Suite 540, Seattle, WA, USA.Kettering Health, 405 W. Grand Ave., Dayton, OH, 45405, USAWellSpan Health, 1001 S. George St. PO Box 15198, York, 17405-7198, PASeattle Science Foundation, Seattle, WA, 98122, USAOSS Health, 1855 Powder Mill Rd #111, York, 17402, PA, USAIntroduction: Cervical stenosis may be treated surgically with anterior or posterior decompression with or without fixation. Recently, facet fusion using implantable devices using a posterior approach has been described as an alternative to anterior cervical discectomy and fusion (ACDF). To our knowledge, no anatomic studies have compared the surface area of the cervical facet joints to the intervertebral space. This study sought to provide a better understanding of the potential surface areas for arthrodesis. Methods: We performed a cross-sectional retrospective review using CT scans of the cervical spine in patients who had undergone imaging between 2014 and 2017. Using our institution's imaging software, we measured the area contained within the intervertebral space and the facet joints bilaterally. All surface area values for each intervertebral space were then compared using a paired t-test to the cumulative surface area of the facet joints calculated at each level. Results: Two hundred twelve patients (120 male, 92 female) were eligible for the analysis based on the inclusion and exclusion criteria. The mean age was 33 ± 6.0 years (range 18–55). The mean BMI was 29 ± 7.2 (range 19–58). In each of the comparisons, the combined intra-facet joint surface area (IFSA) was significantly greater than the intervertebral surface area (IVSA) of the corresponding interbody space. Conclusion: The surface area between the combined facet joints was almost two times greater than the intervertebral space. This may help establish an anatomic basis for comparable fusion results between the traditional ACDF and posterior fusion.http://www.sciencedirect.com/science/article/pii/S259013972500047XAnterior cervical discectomy and fusionCervical stenosisCervical fusionCervical arthrodesisIntra-facet joint surface areaIntervertebral surface area
spellingShingle Christopher Seidel
Clifford Pierre
Luke Jouppi
Luke DiPasquale
Chelsea Bush
Anna Anderson
Amit R. Patel
Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc space
World Neurosurgery: X
Anterior cervical discectomy and fusion
Cervical stenosis
Cervical fusion
Cervical arthrodesis
Intra-facet joint surface area
Intervertebral surface area
title Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc space
title_full Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc space
title_fullStr Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc space
title_full_unstemmed Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc space
title_short Real estate for fusion: An anatomical comparison of surface area between cervical facet joints and the intervertebral disc space
title_sort real estate for fusion an anatomical comparison of surface area between cervical facet joints and the intervertebral disc space
topic Anterior cervical discectomy and fusion
Cervical stenosis
Cervical fusion
Cervical arthrodesis
Intra-facet joint surface area
Intervertebral surface area
url http://www.sciencedirect.com/science/article/pii/S259013972500047X
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