Dynesys Dynamic Stabilization Technique and Fusion Technique as Treatments for Degenerative Lumbar Disease: A Short-Term Comparative Clinical Study

Abstract

Introduction More than 2 years after surgery, the short-term results of Dynesys dynamic stabilization technique and fusion technique used for the patients with degenerative lumbar disease were compared, to evaluate the efficacy of Dynesys system and its prevention for adjacent segment disease. Materials and Methods From December 2008 to November 2010, 70 patients who got single segment fixation underwent Dynesys dynamic stabilization, and then they were followed up for 24 to 47 months (average 33 months). The surgery duration, blood loss, hospital time, operative outcomes, ODI scores, VAS scores between preoperation and postoperation, and the ROM of operative segment and upper segment postoperatively were evaluated and compared with those of the 70 cases who got single segment lumbar spinal fusion in the same period. Results The pain and neurological function were improved obviously and there was no screws loosen, fracture, and displacement in both groups by the latest follow-up. When after 2 years postoperatively, outcomes of Dynesys group and fusion group were 93.15 and 90.67% retrospectively. Surgical duration, blood loss, and hospital time were less in Dynesys group than in fusion group; however, ODI and VAS scores were found no difference in the both groups. The ROM of operative segment was greater in Dynesys group than in fusion group; however, the ROM of upper segment was found no difference between the groups. Adjacent segment disease occurred in two cases (2/70, 2.9%) belonged to fusion group. Conclusion With right indications preoperationally, compared with fusion technique, Dynesys technique contributed to reducing operative invasion and hospital stay, getting the good efficacy. And whether it could reduce the incidence of adjacent segment disease needs more long-term follow-up. Disclosure of Interest None declared References Dubois G, de Germay B, Prere J, et al. Dynamic neutralisation: treatment of mobile vertebral instability. In: Spinal Restabilization Procedures. Amsterdam, The Netherlands: Elsevier; 2002:345–354 Lawhorne TW III, Girardi FP, Mina CA, Pappou I, Cammisa FP Jr. Treatment of degenerative spondylolisthesis: potential impact of dynamic stabilization based on imaging analysis. Eur Spine J 2009;18(6):815–822 Schwarzenbach O, Berlemann U. [Dynamic posterior stabilization with the pedicle screw system DYNESYS®]. Oper Orthop Traumatol 2010;22(5-6):545–557 Putzier M, Schneider SV, Funk J, Perka C. [Application of a dynamic pedicle screw system (DYNESYS) for lumbar segmental degenerations - comparison of clinical and radiological results for different indications]. Z Orthop Ihre Grenzgeb 2004;142(2):166–173 Klöckner C, Beck A. [Polysegmental Dynesys system]. Orthopade 2011;40(2):156–161 Di Silvestre M, Lolli F, Bakaloudis G, Parisini P. Dynamic stabilization for degenerative lumbar scoliosis in elderly patients. Spine 2010;35(2):227–234 Grob D, Benini A, Junge A, Mannion AF. 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 2005;30(3):324–331 Bothmann M, Kast E, Boldt GJ, Oberle J. Dynesys fixation for lumbar spine degeneration. Neurosurg Rev 2008;31(2):189–196 Klöckner C. [Long-term results of the Dynesys implant]. Orthopade 2010;39(6):559–564 Němec F, Ryba L, Repko M, Chaloupka R. [Quality of life in the patients treated for degenerative lumbar spinal stenosis: a three-year follow-up study]. Acta Chir Orthop Traumatol Cech 2010;77(6):484–488 Hoppe S, Schwarzenbach O, Aghayev E, Bonel H, Berlemann U. Long-term outcome after monosegmental l4/5 stabilization for degenerative spondylolisthesis with the Dynesys device. J Spinal Disord Tech 2012 Yu SW, Yen CY, Wu CH, Kao FC, Kao YH, Tu YK. Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years. Arch Orthop Trauma Surg 2012;132(5):583–589