Dynesys dynamic fixation and lumbar spinal fusion for treatment of lumbar degenerative disease: a clinical comparative study

Abstract

Objective To evaluate the value of Dynesys dynamic fixation for treatment of lumbar degenerative disease by comparing with lumbar spinal fusion.Methods The clinical data of 60 patients with lumbar degenerative disease,who were treated in Changhai Hospital from June 2009 to June 2010,were retrospectively analyzed.Twenty-six patients,including 15 males and 11 females,with age ranging 32-56years(average[42.45±10.12]years),received Dynesys implantation for segments L4-L5(13cases)and L5-S1(13cases).Thirty-four patients,including 20 males and 14 females,with age ranging 38-60years(average[45.24±12.15]years),received fusion implantation for segments L4-L5(18cases)and L5-S1(16cases).The following parameters were observed and compared between the two groups:operation time,blood loss,hospital stay,preoperative Oswestry disability index(ODI),ODI at last follow-up,low back and leg pain visual analogue scale(VAS),results of health status questionnaire(SF-36),segmental angulation degree of lumbar spine,and intervertebral height.Results All the 60 patients were followed up for 3-4years(average[3.2±0.2]years).The operation time and intra-operative blood loss were significantly different between the two groups(P0.05),and no difference was found for average hospital days.The ODI,VAS,and SF-36 clinical scores at last follow-up were significantly improved compared with those before operation in the two groups(P0.01),with the improvement in Dynesys group being more significant than the fusion group(P0.01).The segmental angulation degree of lumbar spine had no noticeable improvement in the two groups at last followup,and there were no significant differences between the two groups.There was no intervertebral height loss at the last follow-up in the two groups,and there was no significant difference in intervertebral heights between the two groups.ConclusionDynesys dynamic lumbar fixation shows no more advantages in terms of radiological results compared with the fusion group.Moreover,fusion fixation is not suggested to have more adjacent segment degeneration(ASD)than Dynesys dynamic lumbar fixation.But clinically Dynesys dynamic lumbar fixation yields a greater improvement,with the advantages of less bleeding and shorter operation time.In middle-aged and elderly patients with degenerative diseases,Dynesys dynamic lumbar fixation is an acceptable choice.