Effect of Facet Fusion in Single-Level Fixation for Cervical Degenerative Spondylolisthesis

Study Design: A retrospective observational study. Objective: To compare radiographic and clinical outcomes between laminoplasty alone and facet fusion with fixation in cervical degenerative spondylolisthesis. Background: The optimal surgical strategy for cervical spondylotic myelopathy (CSM) with single-level degenerative spondylolisthesis remains controversial. Materials and Methods: Twenty-eight patients with CSM and single-level spondylolisthesis who underwent posterior cervical surgery between 2017 and 2025 were collected. Patients were divided into laminoplasty alone (L group, n = 14) and laminoplasty with facet fusion using lateral mass screw fixation (F group, n = 14). Radiographic parameters, including slip percentage (% slip), foraminal area, and disc height, were evaluated preoperatively, postoperatively, and at 2-year follow-up. Clinical outcomes included Numerical Rating Scale (NRS) scores for neck and hand pain and numbness, and EuroQol-5 Dimensions (EQ-5D). Results: Both groups demonstrated improvement in pain and numbness after surgery, with no significant differences in clinical outcomes. However, the F group showed significantly greater radiographic improvement. Mean %slip improved from 20.5% to 4.8% postoperatively and was maintained at 5.6% at 2 years, whereas the L group showed progression from 16.1% to 22.6%. Foraminal area increased bilaterally, and disc height was preserved in the F group, while minimal changes and disc height reduction were observed in the L group. Solid bone union was achieved in all patients in the F group. Conclusions: Facet fusion combined with laminoplasty provides radiographic stabilization compared with laminoplasty alone in patients with single-level cervical degenerative spondylolisthesis.