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Archives of Orthopaedic and Trauma Surgery

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01-05-2012 | Orthopaedic Surgery

Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years

Authors: Shang-Won Yu, Cheng-Yo Yen, Chin-Hsien Wu, Feng-Chen Kao, Yu-Hsien Kao, Yuan-Kun Tu

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2012

Abstract

Background

This study aims to compare radiographic and clinical outcomes of Dynesys and posterior lumbar interbody fusion (PLIF) for the treatment of multisegment disease.

Methods

Thirty-five consecutive patients who received Dynesys implantation at three levels from L1 to S1 from November 2006 to July 2007 were studied. A retrospective analysis of the medical records of 25 patients with the same indications who received 3-level PLIF (L1–S1) was also conducted. Radiographic and clinical outcomes between the groups were compared. All patients included in the analysis completed 3-year follow-up. Dynesys stabilization resulted in higher preservation of motion at the operative levels, as well as total range of motion from L1 to S1. A decrease of anterior disc height was seen in the Dynesys group and an increase was seen in the PLIF group. An increase in posterior disc height was noted in both groups; however, was greater in the PLIF group at 3 years.

Results

The Dynesys group showed a greater improvement in Oswestry Disability Index and visual analogue scale back pain scores at 3 years postoperatively. There were no differences in complications between the two groups.

Conclusion

In conclusion, Dynesys is an acceptable alternative to PLIF for the treatment of multisegment lumbar disease.

Resnick DK, Choudhri TF, Dailey AT, Groff MW, Khoo L, Matz PG, Mummaneni P, Watters WC 3rd, Wang J, Walters BC, Hadley MN (2005) American Association of Neurological Surgeons/Congress of Neurological Surgeons. Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 5: correlation between radiographic and functional outcome. J Neurosurg Spine 2:658–661PubMedCrossRef

Kumar MN, Baklanov A, Chopin D (2001) Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J 10:314–319PubMedCrossRef

Chou WY, Hsu CJ, Chang WN, Wong CY (2002) Adjacent segment degeneration after lumbar spinal posterolateral fusion with instrumentation in elderly patients. Arch Orthop Trauma Surg 122:39–43PubMed

Okuda S, Iwasaki M, Miyauchi A, Aono H, Morita M, Yamamoto T (2004) Risk factors for adjacent segment degeneration after PLIF. Spine (Phila Pa 1976) 29:1535–1540CrossRef

Miyakoshi N, Abe E, Shimada Y, Okuyama K, Suzuki T, Sato K (2000) Outcome of one level posterior lumbar interbody fusion for spondylolisthesis and postoperative intervertebral disc degeneration adjacent to the fusion. Spine (Phila Pa 1976) 25:1837–1842CrossRef

Dynesys^® Dynamic Stabilization System. Dynesys LIS surgical technique. Zimmer, Inc., Minneapolis

Beastall J, Karadimas E, Siddiqui M, Nicol M, Hughes J, Smith F, Wardlaw D (2007) The Dynesys lumbar spinal stabilization system: a preliminary report on positional magnetic resonance imaging findings. Spine (Phila Pa 1976) 32:685–690CrossRef

Schwarzenbach O, Berlemann U, Stoll TM, Dubois G (2005) Posterior dynamic stabilization systems: DYNESYS. Orthop Clin North Am 36:363–372PubMedCrossRef

Schnake KJ, Schaeren S, Jeanneret B (2006) Dynamic stabilization in addition to decompression for lumbar spinal stenosis with degenerative spondylolisthesis. Spine (Phila Pa 1976) 31:442–449CrossRef

10.

Bordes-Monmeneu M, Bordes-Garcia V, Rodrigo-Baeza F, Saez D (2005) System of dynamic neutralization in the lumbar spine: experience on 94 cases. Neurocirugia (Astur) 16:499–506 (article in Spanish)

11.

Putzier M, Schneider SV, Funk JF, Tohtz SW, Perka C (2005) The surgical treatment of the lumbar disc prolapse: nucleotomy with additional transpedicular dynamic stabilization versus nucleotomy alone. Spine (Phila Pa 1976) 30:E109–E114CrossRef

12.

Stoll TM, Dubois G, Schwarzenbach O (2002) The dynamic neutralization system for the spine: a multi-center study of a novel non-fusion system. Eur Spine J 11(Suppl 2):S170–S178PubMed

13.

Welch WC, Cheng BC, Awad TE, Davis R, Maxwell JH, Delamarter R, Wingate JK, Sherman J, Macenski MM (2007) Clinical outcomes of the Dynesys dynamic neutralization system: 1-year preliminary results. Neurosurg Focus 22:E8PubMedCrossRef

14.

Lee SE, Park SB, Jahng TA, Chung CK, Kim HJ (2008) Clinical experience of the dynamic stabilization system for the degenerative spine disease. J Korean Neurosurg Soc 43:221–226PubMedCrossRef

15.

Nockels RP (2005) Dynamic stabilization in the surgical management of painful lumbar spinal disorders. Spine (Phila Pa 1976) 30(Suppl 16):S68–S72CrossRef

16.

Schmoelz W, Huber JF, Nydegger T, Dipl-Ing, Claes L, Wilke HJ (2003) Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment. J Spinal Disord Tech 16:418–423PubMedCrossRef

17.

Liu CL, Zhong ZC, Shih SL, Hung C, Lee YE, Chen CS (2010) Influence of Dynesys system screw profile on adjacent segment and screw. J Spinal Disord Tech 23:410–417PubMedCrossRef

18.

Delank KS, Gercek E, Kuhn S, Hartmann F, Hely H, Röllinghoff M, Rothschild MA, Stützer H, Sobottke R, Eysel P (2010) How does spinal canal decompression and dorsal stabilization affect segmental mobility? A biomechanical study. Arch Orthop Trauma Surg 130:285–292PubMedCrossRef

19.

Vaga S, Brayda-Bruno M, Perona F, Fornari M, Raimondi MT, Petruzzi M, Grava G, Costa F, Caiani EG, Lamartina C (2009) Molecular MR imaging for the evaluation of the effect of dynamic stabilization on lumbar intervertebral discs. Eur Spine J 18(Suppl 1):40–48PubMedCrossRef

20.

Cheng BC, Gordon J, Cheng J, Welch WC (2007) Immediate biomechanical effects of lumbar posterior dynamic stabilization above a circumferential fusion. Spine (Phila Pa 1976) 32:2551–2557CrossRef

21.

Niosi CA, Zhu QA, Wilson DC, Keynan O, Wilson DR, Oxland TR (2006) Biomechanical characterization of the three-dimensional kinematic behaviour of the Dynesys dynamic stabilization system: an in vitro study. Eur Spine J 15:913–922PubMedCrossRef

22.

Kim CH, Chung CK, Jahng TA (2011) Comparisons of outcomes after single or multilevel dynamic stabilization: effects on adjacent segment. J Spinal Disord Tech 24:60–67PubMedCrossRef

23.

Klöckner C, Beck A (2011) Polysegmental Dynesys system. Orthopade 40:156–161 (article in German)PubMedCrossRef

24.

Dakhil-Jerew F, Jadeja H, Cohen A, Shepperd JA (2009) Inter-observer reliability of detecting Dynesys pedicle screw using plain X-rays: a study on 50 post-operative patients. Eur Spine J 18:1486–1493PubMedCrossRef

25.

Schaeren S, Broger I, Jeanneret B (2008) Minimum four-year follow-up of spinal stenosis with degenerative spondylolisthesis treated with decompression and dynamic stabilization. Spine (Phila Pa 1976) 33:E636–E642CrossRef

26.

Kumar A, Beastall J, Hughes J, Karadimas EJ, Nicol M, Smith F, Wardlaw D (2008) Disc changes in the bridged and adjacent segments after Dynesys dynamic stabilization system after two years. Spine (Phila Pa 1976) 33:2909–2914CrossRef

27.

Rahm MD, Hall BB (1996) Adjacent-segment degeneration after lumbar fusion with instrumentation: a retrospective study. J Spinal Disord 9:392–400PubMedCrossRef

28.

Ko CC, Tsai HW, Huang WC, Wu JC, Chen YC, Shih YH, Chen HC, Wu CL, Cheng H (2010) Screw loosening in the Dynesys stabilization system: radiographic evidence and effect on outcomes. Neurosurg Focus 28:E10PubMedCrossRef

29.

Würgler-Hauri CC, Kalbarczyk A, Wiesli M, Landolt H, Fandino J (2008) Dynamic neutralization of the lumbar spine after microsurgical decompression in acquired lumbar spinal stenosis and segmental instability. Spine (Phila Pa 1976) 33:E66–E72CrossRef

30.

Grob D, Benini A, Junge A, Mannion AF (2005) Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years. Spine (Phila Pa 1976) 30:324–331CrossRef

Title: Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years
Authors: Shang-Won Yu
Cheng-Yo Yen
Chin-Hsien Wu
Feng-Chen Kao
Yu-Hsien Kao
Yuan-Kun Tu
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2012
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-012-1460-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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