Dynamic posterior stabilization for degenerative lumbar spine disease: a large consecutive case series with long-term follow-up by additional postal survey.

Abstract

Dynamic stabilization of the degenerated spine was invented to overcome the negative side effects of fusion surgery like adjacent segment degeneration. Amongst various different implants DSS(®) is a pedicle-based dynamic device for stabilizing the spine and preserving motion. Nearly no clinical data of the implant have been reported so far. The current analysis presents results from a single spine surgeon who has been using DSS(®) for the past 5years and recorded all treatment and outcome data in the international Spine Tango registry. From the prospectively documented overall patient pool 436 cases treated with DSS(®) could be identified. The analysis was enhanced with a mailing of COMI patient questionnaires for generating longer-term follow-ups up to 4years. 387 patients (189 male, 198 female; mean age 67.3years) with degenerative lumbar spinal disease including degenerative spondylolisthesis (6.1%) could be evaluated. The type of degeneration was mainly spinal stenosis (89.9%). After a mean follow-up of 1.94years, the COMI score and NRS back and leg pain improved significantly and to a clinically relevant extent. The postoperative trend analysis could not determine a relevant deterioration of these outcomes until 4years postoperative. 10 patients were revised (2.6%) and the implant was removed; in most cases, a fusion was performed. Another 5 cases (1.3%) had an extension of the dynamic stabilization system to the adjacent level. 84.2% of patients rated that the surgery had helped a lot or had helped. The results of this large consecutive series with a follow-up up to 4years could demonstrate a good and stable clinical outcome after posterior dynamic stabilization with DSS(®). For degenerative diseases of the lumbar spine, this treatment seems to be a valid alternative to fusion surgery.