Posterior Dynamic Stabilization Research Articles

Biomechanical Effects of the Implant Designed for Posterior Dynamic Stabilization of the Lumbar Spine (L4-L5): A Finite Element Analysis Study

Biomechanical Effects of the Implant Designed for Posterior Dynamic Stabilization of the Lumbar Spine (L4-L5): A Finite Element Analysis Study

Foraminoplasty with Partial Pediculectomy in Degenerative Spondylolisthesis Cases with Nerve Compression.

Degenerative spondylolisthesis refers to a forward displacement of a vertebra relative to the underlying vertebra. Patients with radicular pain and/or neurogenic claudication are considered suitable candidates for surgical intervention. The aim of this study was to present clinical results of dynamic stabilization applied after pediculectomy and neural foramen enlargement in patients with degenerative spondylolisthesis and normal spinal sagittal balance. All patients who underwent pediculectomy and dynamic stabilization for lumbar degenerative spondylolisthesis were retrospectively identified. Diagnosis was made with detailed neurological and radiological imaging examinations for the anatomical location of the pain. Demographic data, visual analog scale scores, and quality-of-life scores were obtained. Patients included 3 (33.3%) men and 6 (66.7%) women with a mean age of 61.3 ± 13.0 years (range, 46-80 years) at initial symptom onset. Grade 1 degenerative spondylolisthesis was present in 5 (55.6%) patients, and grade 2 was present in 4 (44.4%) patients. Pathology was detected in L4-5 in 4 patients (44.4%) and L5-S1 in 5 patients (55.6%). In all patients, at the 3-month follow-up, statistically significant decrease in visual analog scale and Oswestry Disability Index scores was observed. At the last follow-up, no implant-related complications requiring revision were observed. In patients without any pathology in the sagittal balance, the optimal physiological treatment modality can be created by applying posterior dynamic stabilization together with pediculectomy to support the posterior tension band.

Adjacent Segment Disease

Spinal fusion is gold-standard treatment for degenerative disc disease (DDD) both at cervical and lumbar spine, and it is time tested. Perhaps it has its bundle of complications. Elimination of motion results in accentuated degeneration of adjacent segments leading to adjacent segment degeneration radiographically and, if symptomatic, leads to adjacent segment disease. There is still a debate on whether there is such an entity or whether it is a manifestation of natural history or an iatrogenic phenomenon. Motion preservation surgeries were developed to address the same issue, which includes total disc replacement, nucleus replacement, interspinous implants, and dynamic posterior stabilization systems. The primary goal of motion preservation surgery is to maintain normal or near-normal motion in an attempt to prevent adverse outcomes, which are commonly seen with conventional spinal fusion, most notably the development of adjacent-level DDD. A search was conducted in PubMed using the terms (“adjacent segment”) AND (“disease” OR “degeneration” or “pathology”). Then the articles were shortlisted based on time of publication (2005 onward), publication in English and inclusion of human subjects. This resulted in 253 articles. Another search for ((“Motion preservation”) AND (“Spine”)) OR (“Adjacent segment disease”) OR (“Adjacent segment pathology”) OR (“Adjacent segment degeneration”) yielded 76 articles. This narrative review discusses various issues pertaining to the current evidence regarding adjacent segment disease (ASD), including the controversy on whether ASD is actually an entity, its etiopathogenesis, clinical features, as well as the role of motion preservation technologies to reduce its incidence. There is still enthusiasm and concerns regarding the benefits of motion preservation surgery since it is still an area of ongoing research.

Biomechanical analysis of lumbar nonfusion dynamic stabilization using a pedicle screw-based dynamic stabilizer or an interspinous process spacer.

This study aimed to investigate and compare the effects of two widely used nonfusion posterior dynamic stabilization (NPDS) devices, pedicle screw-based dynamic stabilizer (PSDS) and interspinous process spacer (IPS), on biomechanics of the implanted lumbar spine under static and vibration loadings. The finite element model of healthy human lumbosacral segment was modified to incorporate NPDS device insertion at L4-L5 segment. Bioflex and DIAM were used as PSDS-based and IPS-based NPDS devices, respectively. As a comparison, lumbar interbody fusion with rigid stabilization was also simulated at L4-L5. For static loading, segmental range of motion (ROM) of the models under moments of four physiological motions was computed using hybrid testing protocol. For vibration loading, resonant modes and dynamic stress of the models under vertical excitation were extracted through random response analysis. The results showed that compared with the rigid fusion model, ROM of the nonfusion models was higher at L4-L5 level but lower at adjacent levels (L1- L2, L2-L3, L3-L4, L5-S1). Compared with the Bioflex model, the DIAM model produced higher ROM at L4-L5 level but lower ROM at adjacent levels, especially under lateral bending and axial rotation; resonant frequency of the DIAM model was slightly lower; dynamic response of nucleus stress at L4-L5 level was slightly higher for the DIAM model, and the dynamic stress at adjacent levels was no obvious difference between the nonfusion models. This study reveals biomechanical differences between the Bioflex and DIAM systems, which may provide references for selecting surgical approaches in clinical practice.

Preliminary Results of a Prospective Clinical and Radiological Study with Roentgen Stereophotogrammetric Analysis (RSA) after Implantation of a Posterior Dynamic Stabilization Device in the Lumbar Spine

Introduction: Posterior dynamic stabilization (PDS) can be based on interspinous distraction devices (IDD). The goals of these implants are maintaining or restoring intervertebral range of motion (ROM) in a controlled fashion and avoiding a complete restriction of mobility. Clinical and radiological data with the Wallis® spacer as one type of IDD have been rarely reported. The goal of this study was to present clinical and radiological data including roentgen stereophotogrammetric analysis (RSA) after a short- to mid-term follow-up period.
 Patients and Methods: 10 patients were included in this prospective monocentric study and had PDS of the lumbar spine with an IDD (Wallis® spacer). Before and soon after operation and 3, 6, and 12 months later clinical and radiological evaluations were performed. Pain and disability were analyzed by use of visual analog scale for back and leg pain, Oswestry Disability Index, Roland-Morris Disability Questionnaire and Short-Form-36 Health Survey. The ROM of the operated levels and the total lumbar spine was determined by use of lateral functional x-ray images with calculation of the differences of the segmental and total lumbar spine angles in flexion and extension. Furthermore, RSA was used to measure the segmental ROM.
 Results: After a follow-up of 12 months, the results of the pain intensity and the disability and health related quality of life scores showed statistical significant improvement. The segmental angles of the operated levels demonstrated statistical significant reduction in ROM during the different follow-up examinations. The discrepancy of the conventionally determined segmental angles and the data measured by RSA were low with a mean of 1.77°. The mean total lumbar spine angles did not change statistically significantly during the postoperative controls.
 Conclusions: According to the radiological results of this study, the used implant leads to a posterior dynamic stabilization. The clinical findings are promising, but they are to be interpreted with caution because of the small number of patients and the lack of a control group.

Assessment of outcome of posterior dynamic stabilization system in degenerative lumbar disease

Background: Degenerative disc disease is a leading cause of chronic back pain in the aging population in the world. The present study was conducted to assess outcome of posterior dynamic stabilization system in degenerative lumbar diseases. Materials & Methods: 78 patients of degenerative lumbar diseases of both genders were divided into 2 groups of 39 each. Group I patients underwent decompression and implantation of Dynesys and group II patients underwent PLIF. ODI, VAS scores for back pain and leg pain, operation time, blood loss, and complications were compared in both groups. Results: There were 25 males and 14 females in group I and 20 males and 19 females in group II. The operative time (min) was 136.2 in group I and 172.4 in group II. Blood loss (ml) was 362.4 in group I and 438.2 in group II. Complications were dural tear seen 2 in group II, wound infection was seen in 1 in group II, screw loosening was 1 in group I and 2 in group II and back & leg pain seen 3 in group I and 4 in group II. The mean ODI was 32.5 and 38.5, VAS back pain was 2.6 and 3.12.

Posterior Dynamic Stabilization with Limited Rediscectomy for Recurrent Lumbar Disc Herniation.

Objective Recurrent lumbar disc herniation (RLDH) is the most common cause of sciatica after primary discectomy. The purpose of this study was to evaluate the efficacy of transpedicular dynamic stabilization (TDS) combined with limited rediscectomy in the treatment of single-level RLDH. Methods We retrospectively evaluated a consecutive series of 24 middle-aged patients who underwent TDS (Dynesys system) combined with limited rediscectomy (i.e., removing only extruded or loose disc fragments) for single-level Carragee type II and type IV RLDH between April 2012 and September 2017. Clinical results were evaluated with visual analog scale (VAS) for leg and low back pain, Oswestry Disability Index (ODI) scores, and complications. Imaging data include lumbar segment motion and intervertebral height. Results The mean follow-up period was 38 months. The VAS and ODI scores were significantly improved at the last follow-up. The average range of motion (ROM) at the stabilized segment was 6.4° before surgery and 4.2° at the last follow-up, with a 78.6% mean preservation (P < 0.05). Intervertebral height at the stabilized segment decreased slightly after surgery (P < 0.05). However, there was no further decline at the last follow-up. There were no cases of reherniation, screw loosening, or segmental instability. Conclusions TDS combined with limited rediscectomy resulted in an effective procedure in middle-aged patients with Carragee type II and type IV RLDH. It was able to stabilize the operated segment with partial motion preservation. Moreover, it could maintain disc height and decrease the risk of recurrence in patients with a large posterior annular defect.

Current concepts of spondylosis and posterior spinal motion preservation for radiologists.

Spinal fusion is performed to eliminate motion at a degenerated or unstable segment. However, this is associated with loss of motion at the fused levels and increased stress on adjacent levels. Motion-preserving implants have been designed in effort to mitigate the limitations of fusion. This review will focus on posterior spinal motion-preserving technologies. In the cervical spine, laminoplasty is a posterior motion-preserving procedure used in the management of myelopathy/cord compression. In the lumbar spine, motion-sparing systems include interspinous process devices (also referred to as interspinous process spacers or distraction devices), posterior dynamic stabilization devices (also referred to as pedicle screw/rod fixation-based systems), and posterior element replacement systems (also referred to as total facet replacement devices). Knowledge of the intended physiologic purpose, hardware utilized, and complications is important in the assessment of imaging in those who have undergone posterior motion preservation procedures.

Fatigue wear test comparing vitamin-E-blended crosslinked polyethylene and conventional polyethylene in a Posterior Dynamic Stabilization System of the spine in the laboratory

BackgroundAlthough artificial joints using polyethylene have been developed for various joints, the development of Posterior Dynamic Stabilization system of the spine using polyethylene has proceeded at a much slower pace. There are no studies which compare the abrasion resistance of vitamin-E-blended crosslinked polyethylene (VE) and conventional polyethylene (Virgin) in the spinal region. The purpose of this study was to compare the wear resistance of VE and Virgin in a Posterior Dynamic Stabilization System of the spine. MethodsPosterior Dynamic Stabilization System of the spine uses a polyethylene ball as a sliding surface. A fatigue wear test was repeated up to 1 million cycles at a speed of ±5°, 1 Hz while the rod was being pulled at a load of 50 N. Balls were compared using VE and Virgin in 6 samples each. Ti-6AL-4 V (Ti 64) and Co–Cr–Mo (CoCr) rods were used. Abrasion loss and shape change of the polyethylene balls were compared. ResultsWhen Ti 64 was used as the rod, the average wear amount was −0.01 mg (0.02 mg, 0.01 mg, −0.06 mg) for VE, and 0.23 mg (0.18 mg, 0.13 mg, 0.38 mg) for Virgin. When CoCr was used as the rod, the average wear amount was 0.42 mg (0.71 mg, −0.06 mg, 0.61 mg) for VE, and 0.73 mg (0.72 mg, 0.70 mg, 0.76 mg) for Virgin. Most polyethylene samples showed indentations of 0.1 m or less at the contact point with the set screw. In the combination of Virgin and CoCr, a white patch was observed on the inner side of the polyethylene samples, with a maximum depression of 0.1 mm. ConclusionsA fatigue wear test showed VE to be more efficient in abrasion resistance than Virgin in a Posterior Dynamic Stabilization System of the spine in the laboratory.

Kyphoplasty with Posterior Dynamic Stabilization in the Surgical Treatment of Unstable Thoracolumbar Osteoporotic Vertebral Compression Fractures.

To evaluate the role of posterior dynamic stabilization (PDS) with kyphoplasty (KP) in the surgical treatment of unstable osteoporotic compression fractures, which are common in the elderly population. This study included 25 patients with osteoporotic compression fractures. KP with PDS was performed on all patients. Radiological evaluation was performed with magnetic resonance imaging, computed tomography, and plain radiographs. The vertebral kyphosis angle (VKA), local kyphosis angle (LKA), and percentage of collapse were calculated. Clinical evaluation was performed with the visual analog scale and the Oswestry Disability Index (ODI). The preoperative and postoperative clinical and radiological data were compared. The clinical and radiological parameters showed significant improvement following surgical treatment. The mean preoperative visual analog scale score of 7.78 decreased to 0.94 after 12 months. The mean preoperative ODI score of 70.33 decreased to 15.65 after 12 months. The mean preoperative VKA of 17.89° decreased to 9.22° after 12 months. The mean preoperative LKA of 9.61° decreased to 5.50° after 12 months. The mean preoperative percentage of collapse of 32.56% decreased to 19.00% after 12 months. There were no major complications. KP with the PDS method offered satisfactory outcomes in the surgical treatment of unstable osteoporotic compression fractures.

A Prospective Long-term Follow-up Study of the Posterior Dynamic Stabilizing System to Treat Back Pain Associated With Degenerative Disc Disease.

Study Design:Prospective cohort study.Objective:To evaluate the long-term effectiveness of a posterior dynamic spine stabilization (PDS) System called PercuDyn system as a treatment for low back pain (LBP) in patients with degenerative disc disease who have failed conservative treatment.Methods:Thirty-five patients (21 males, 14 females, mean age 36 years) with chronic LBP due to degenerative disc disease underwent percutaneous facet augmentation with the PercuDyn system. Indications for implanting the PercuDyn device were chronic LBP without sciatica, significant disc degeneration, and who failed conservative treatment. Follow-up after surgery ranged from 4 to 8 years. Patients were clinically evaluated using visual analogue scale (VAS), Oswestry Disability Index (ODI) questionnaire, and the EQ-5D3L.Results:The VAS scale and ODI scores improved at 6 months, 1 year, 2 years, and 4 to 8 years in comparison with the baseline values (P < .001 and P < .01, respectively). Equally, data from the EQ-5D-3L questionnaire suggested improvements in all domains, including pain and discomfort, over the follow-up period. However, during follow-up, 16 patients (46%) have had unsatisfactory outcome including failure of implant to resolve symptoms (n = 8), developed symptomatic disc protrusion (n = 4), and loosening of the screws (n = 4).Conclusion:Our clinical experience highlights the rather high overall failure rate of this system. Although, some patients show significant improvement in their symptoms, we believe that patients with LBP related to degenerative disc disease are a poor indication for this PDS device.However, large scale studies, with optimised selection criteria are needed to demonstrate the exact role of this device in spinal patients.

Durability and Biological Response of a New Posterior Dynamic Stabilization System Using Polyethylene with Vitamin E.

Objective The purpose of this study was to evaluate the durability and biological response of a new Posterior Dynamic Stabilization system using polyethylene with vitamin E on the sliding surface. Summary of Background Data The use of polyethylene with vitamin E on the sliding surface in Posterior Dynamic Stabilization has not been reported previously. Methods A developed pedicle screw-based Posterior Dynamic system consists of four parts: a set screw, a rod, a ball, and a pedicle screw. The rod is inserted into the through hole of the ball, and the ball is sandwiched by the set screw. (1) Fatigue Wear Test. Testing was conducted under a dynamic compressive load of 50N at a speed of 1 Hz for 1 million cycles. We examined the loss of polyethylene due to abrasion in 3 units. (2) Biological Response in Pigs. In two pigs, a new pedicle screw and a conventional pedicle screw were inserted in L2 and L3/4, and L4 and L2/3, respectively. After breeding for 6 months, autopsies were performed. CT imaging was used to evaluate bone union of the facet joint. Abrasive specimens were prepared, and abrasion powder and inflammatory cell infiltration were evaluated microscopically. Results The average loss of polyethylene due to abrasion was -0.01 mg. In all units, polyethylene showed a decrease of 0.1 mm or less at the contact point with the set screw. The facet joints between the conventional screws exhibited bone fusion, but the facet joint between the conventional and the new screw retained mobility with no bony fusion. No abrasion powder was found and inflammatory cell infiltration was only minimally observed. Conclusion The new Posterior Dynamic Stabilization system exhibited a high level of durability and biological safety.

Dynamic stabilization for degenerative diseases in the lumbar spine: 2 years results.

Following lumbar fusion, adjacent segment degeneration has been frequently reported. Dynamic systems are believed to reduce main fusion drawbacks. We conducted a retrospective study on patients with degenerative lumbar disease treated with posterior dynamic stabilization with monoaxial hinged pedicular screws and lumbar decompression. VAS and ODI were used to compare clinical outcomes. As radiological outcomes, LL and SVA were used. 51 patients were included with an average follow-up of 24 months. 13 patients were revised because of postoperative radiculopathy (n=4), subcutaneous hematoma (n=2), L5 screw malposition (n=1) and adjacent segment disease (n=6). The mean ODI score 41 preoperatively compared to 36 postoperatively. The mean VAS scores for back and leg pain were 5.3 and 4.2, respectively compared to 4.5 and 4.0 postoperatively. The mean SVA was 5.3 cm preoperatively, and 5.7 cm postoperatively. The mean LL was 47.5° preoperatively and 45.5° postoperatively. From our data, which fail to show significant improvements and reflect a high revision rate, we cannot generally recommend dynamic stabilization as an alternative to fusion. Comparative trials with longer follow-ups are required.

Spinal motion preservation surgery: indications and applications.

Fusion is one of the most commonly performed spinal procedures, indicated for a wide range of spinal problems. Elimination of motion though results in accelerated degeneration of the adjacent level, known as adjacent level disease. Motion preservation surgical methods were developed in order to overcome this complication. These methods include total disc replacement, laminoplasty, interspinous implants and dynamic posterior stabilization systems. The initial enthusiasm about these methods was followed by certain concerns about their clinical usefulness and their results. The main indications for total disc replacement are degenerative disc disease, but the numerous contraindications for this method make it difficult to find the right candidate. Application of interspinous implants has shown good results in patients with spinal stenosis, but a more precise definition is needed regarding the severity of spinal stenosis up to which these implants can be used. Laminoplasty has several advantages and less complications compared to fusion and laminectomy in patients with cervical myelopathy/radiculopathy. Dynamic posterior stabilization could replace conventional fusion in certain cases, but also in this case the results are successful only in mild to moderate cases.

The influence of L4\u2013S1 Dynesys\xae dynamic stabilization versus fusion on lumbar motion and its relationship with lumbar degeneration: a retrospective study

BackgroundThe aim of this study is to evaluate the efficacy of Dynesys® posterior dynamic stabilization (PDS) in the treatment of L4–S1 degenerative diseases and to assess the influence of postoperative motion on lumbar degeneration.MethodsIncluded in this retrospective study were patients with L4–S1 degenerative disease who underwent fusion or PDS from September 2010 to September 2014. Clinical outcomes were assessed by preoperative and postoperative visual analog scale (VAS) and Oswestry Disability Index (ODI). Preoperative and postoperative X-rays assessed range of motion (ROM) of the non-surgical and surgical levels and whole lumbar. MRI assessed degeneration of non-surgical levels.ResultsA total of 56 consecutive patients were divided into two groups: group A, PDS, and group B, fusion. Patient demographics and baseline characteristics were similar in the two groups. In both groups, there was a significant difference between preoperative and postoperative VAS and ODI scores (P < 0.05). However, there was a significant difference in a 6-month follow-up ODI between the two groups (P < 0.05). X-rays showed PDS patients partially maintained surgical level ROM and non-surgical level ROM increased less than in the fusion group. MRI showed adjacent segment degeneration (ASD) in both groups, and patients whose preoperative L3–4 Pfirrmann classification was higher than grade 2 had more ASD than lower than grade 2.ConclusionPDS can maintain surgical level ROM and had less influence on whole and non-surgical level ROM. Following PDS, patients recovered faster and had a better lumbar function. It may be a better choice for multi-level lumbar degenerative diseases.

In vitro oxidative degradation of a spinal posterior dynamic stabilization device.

This study quantified the changes of the frequency-dependant viscoelastic properties of the BDyn (S14 Implants, Pessac, France) spinal posterior dynamic stabilization (PDS) device due to in vitro oxidation. Six polycarbonate urethane (PCU) rings and six silicone cushions were degraded using a 20% hydrogen peroxide/0.1 M cobalt (II) chloride hexahydrate, at 37°C, for 24 days. The viscoelastic properties of the individual components and the components assembled into the BDyn PDS device were determined using Dynamic Mechanical Analysis at frequencies from 0.01 to 30 Hz. Attenuated Total Reflectance Fourier Transform Infra-Red spectra demonstrated chemical structure changes, of the PCU, associated with oxidation while Scanning Electron Microscope images revealed surface pitting. No chemical structure or surface morphology changes were observed for the silicone cushion. The BDyn device storage and loss stiffness ranged between 84.46 N/mm to 99.36 N/mm and 8.13 N/mm to 21.99 N/mm, respectively. The storage and loss stiffness for the components and BDyn device increased logarithmically with respect to frequency. Viscoelastic properties, between normal and degraded components, were significantly different for specific frequencies only. This study demonstrates the importance of analyzing changes of viscoelastic properties of degraded biomaterials and medical devices into which they are incorporated, using a frequency sweep. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1237-1244, 2018.

Unwarranted Complication in Posterior Dynamic Stabilization of the Spine: Review of Literature and Description of a Case Encountered by the Author

Unwarranted Complication in Posterior Dynamic Stabilization of the Spine: Review of Literature and Description of a Case Encountered by the Author

Internal decompression for spinal stenosis (IDSS) for decompression and use of interlaminar dynamic device (CoflexTM) for stabilization in the surgical management of degenerative lumbar canal stenosis with or without mild segmental instability: our initial results

Introduction: Internal decompression of spinal stenosis (IDSS) and Posterior dynamic stabilization (PDS) form a bridge between decompression laminectomy alone and rigid fusion, by attempting to sustain beneficial effects of decompression and stabilization in an attempt to prevent bad effects of relentless degeneration.Objective: To evaluate the clinical outcome in operated patient of posterior dynamic stabilization.Design: Data were collected over 1 year in prospective, nonrandomized follow-up study using outcome scales.Setting: Single surgeon, tertiary care centre in Mumbai, India.Described here is the operative technique of posterior dynamic stabilization using CoFlexTM and clinical outcome of 67 consecutive patients using Visual Analogue Scale and Oswestry Disability Score.

SURGICAL TREATMENT OF DISC HERNIATION IN CHILDREN AND ADOLESCENTS

Objective. To analyze the features of surgical treatment of children and adolescents with herniated discs and radicular compression symptoms. Material and Methods . A retrospective multicenter study of 34 patients with juvenile osteochondrosis with mean age of 15.4 years was performed. Surgical treatment included disc puncture methods, microdiscectomy through posterior approach, anterior discectomy, dynamic and rigid stabilization, and replacement of the fibrous ring defect. Results . Positive clinical effect with complete relief of pain was achieved in all cases. Paretic syndrome regressed completely in all patients. All patients regained the level of physical activity in the next 2-3 months. Long-term follow-up was on average 45.5 months. No recurrence of pain was noted during the follow-up period. Conclusion . Surgical treatment of disc herniation in children results in the relief of pain and full functional recovery. Among surgical methods, a preference should be given to microdiscectomy through minimally invasive surgical approaches. In the presence of indications, both rigid stabilization of spinal motion segment at the level of decompression and dynamic stabilization can be performed, and the latter is more preferable.

The unfeasible made feasible: lumbar minimally invasive hybrid stabilization with dynamic rod and mini-open transforaminal lumbar interbody fusion.

Posterior dynamic stabilization of the lumbar spine is spreading as a viable alternative to spinal fusion, aiming to achieve an equally satisfactory clinical outcome without making the spine completely rigid. We describe the feasibility of a minimally invasive surgical technique used to implant a hybrid system and perform a mini-open (m-open) transforaminal lumbar interbody fusion (TLIF) in patients suffering from degenerative spondylolistesis and adjacent level's degenerative disc disease (DDD). Three patients (2 females), suffering from degenerative spondylolistesis and adjacent level's DDD, underwent two-level hybrid stabilization combining a rigid, circumferential fusion (with m-open TLIF) at the level involved by spondylolistesis and a dynamic stabilization at the adjacent one. Screws, hybrid rods as well as interbody cages were introduced using a simple minimally invasive technique. Clinical and radiological evaluation was performed pre- and postoperatively, and at 3, 6 and 12 months, respectively, using the Visual Analogue Scale and the Oswestry Disability Index questionnaire. Mean VAS and ODI score reduced from 8.3, preoperatively, to 5 and from 72.66 to 43.98, respectively. No surgery-related complications were observed and the mean postoperative hospitalization was 2.5 days. Postoperative and follow-up flexion-extension X-rays showed persisting motion at dynamically stabilized levels. Follow-up CT imaging confirmed interbody fusion at TLIF levels in all patients. Dynamic and hybrid stabilizations of the lumbar spine are typically performed using open surgery. This study reports the feasibility of a hybrid stabilization with m-open TLIF performed using a minimally invasive technique.