Facet Fusion: Surgery, Procedure, Lumbar & Cervical, Devices, CPT Code & Spinal Fusion Comparison

Facet Fusion:

• Surgery
• Procedure
• Lumbar & Cervical
• Devices
• CPT Code
• Spinal Fusion Comparison

Surgery

Facet fusion surgery is a minimally invasive spinal procedure designed to stabilize the facet joints between vertebrae. These joints, located at the back of the spine, can become arthritic, unstable, or painful due to injury, degeneration, or deformity. Fusion eliminates abnormal movement and reduces pain by promoting bone growth between the affected joints.

This surgery is often considered for patients who do not respond to conservative management like physical therapy, injections, or medications. It can be performed alone or in combination with other spinal surgeries, such as decompression or interbody fusion.

Procedure

The procedure typically involves placing a small bone graft or a specially designed implant into the facet joint space. Over time, the graft encourages bone to grow across the joint, permanently joining the two vertebrae.

Surgeons may use minimally invasive approaches with small incisions and specialized instruments, often under fluoroscopic (X-ray) guidance. Recovery time varies but is generally faster than with traditional open spinal fusion due to smaller incisions and reduced muscle disruption.

Lumbar & Cervical

Facet fusion can be performed at different spinal regions:

• Lumbar Facet Fusion: Targets the lower back to treat instability, degenerative changes, or chronic low back pain. It’s often performed for spondylosis, spondylolisthesis, or post-laminectomy instability.
• Cervical Facet Fusion: Addresses pain or instability in the neck region, often after trauma, degeneration, or deformity. Care is taken to preserve range of motion where possible.

Different implant sizes and approaches are used depending on spinal level and pathology.

Devices

Modern facet fusion devices are designed to provide immediate stability and promote fusion. These may include:

• Facet Cages: Small titanium or PEEK devices placed into the facet joint space.
• Facet Screws & Plates: Provide direct stabilization.
• Bone Grafts: Autograft (patient’s own bone) or allograft (donor bone).
• Biologic Enhancers: Bone morphogenetic proteins (BMPs) or demineralized bone matrix to speed fusion.

CPT Code

The Current Procedural Terminology (CPT) codes for facet fusion vary by approach and number of levels:

• 22523 – Arthrodesis, posterior or posterolateral technique, single level; lumbar.
• 22524 – Each additional lumbar level.
• 22590 – Arthrodesis, posterior technique, single level; cervical.

Codes may differ if combined with instrumentation or performed as part of a larger spinal fusion procedure.

Spinal Fusion Comparison

While both facet fusion and traditional spinal fusion aim to stabilize the spine, there are key differences:

Aspect	Facet Fusion	Traditional Spinal Fusion
Target	Facet joints	Entire vertebral segment (including disc space)
Invasiveness	Minimally invasive	Often more invasive
Recovery	Shorter	Longer
Implants	Small facet cages, screws	Larger rods, screws, cages
Indications	Isolated facet instability or degeneration	Wider range of spinal instability and deformities