Graf ligamentoplasty: a 7-year follow-up

Posterior nonfusion pedicle-screw-based stabilization remains a controversial area of spine surgery. To date, the Dynesys system remains the most widely implanted posterior nonfusion pedicle screw system. We review the history of Dynesys and discuss clinical outcome studies and biomechanical evaluations regarding the Dynesys system. Indications for surgery and controversies are discussed. Recommendations are made regarding technical implantation.

Section: Brief Historysupporting

confidence: 86%

Role of Dynesys as Pedicle-Based Nonfusion Stabilization for Degenerative Disc Disorders

Anand

Baron

2012

“…Long-term outcome has conflicting reports. Gardner and Pande [20] and Markwalder and Wenger [21] reported reasonably good result with Graf ligament even at 5–10-year followup. On the other hand, Hadlow et al [18] reviewed their outcome with Graf ligament stabilization in 83 consecutive patients, and reported a worse outcome at 1 year and a significantly higher revision rate at 2 years, compared to instrumented fusion.…”

Section: Clinical Experience With Posterior Dynamic Stabilizationmentioning

confidence: 99%

“…On the other hand, Hadlow et al [18] reviewed their outcome with Graf ligament stabilization in 83 consecutive patients, and reported a worse outcome at 1 year and a significantly higher revision rate at 2 years, compared to instrumented fusion. The Graf ligament is still being used in a few centers in both Europe and Asia, but its use has declined [20, 22]. …”

Section: Clinical Experience With Posterior Dynamic Stabilizationmentioning

confidence: 99%

Pedicle Screw-Based Posterior Dynamic Stabilization: Literature Review

Sengupta

Herkowitz

2012

Posterior dynamic stabilization (PDS) indicates motion preservation devices that are aimed for surgical treatment of activity related mechanical low back pain. A large number of such devices have been introduced during the last 2 decades, without biomechanical design rationale, or clinical evidence of efficacy to address back pain. Implant failure is the commonest complication, which has resulted in withdrawal of some of the PDS devices from the market. In this paper the authors presented the current understanding of clinical instability of lumbar motions segment, proposed a classification, and described the clinical experience of the pedicle screw-based posterior dynamic stabilization devices.

“…Graf ligament as posterior extention band was used in condition of chronic instability resulted from degenerative diseases of the lumbar spine. This concept was supported and used [67–71] and found inconvenient [72, 73] by some surgeons in time. Criticism of Graf ligament focused especially on these concerns which are ligament loosening, foramen narrowing, and flat back.…”

Section: Posterior Dynamic Stabilizationmentioning

confidence: 99%

Dynamic Stabilization for Challenging Lumbar Degenerative Diseases of the Spine: A Review of the Literature

Kaner

Özer

2013

Fusion and rigid instrumentation have been currently the mainstay for the surgical treatment of degenerative diseases of the spine over the last 4 decades. In all over the world the common experience was formed about fusion surgery. Satisfactory results of lumbar spinal fusion appeared completely incompatible and unfavorable within years. Rigid spinal implants along with fusion cause increased stresses of the adjacent segments and have some important disadvantages such as donor site morbidity including pain, wound problems, infections because of longer operating time, pseudarthrosis, and fatigue failure of implants. Alternative spinal implants were developed with time on unsatisfactory outcomes of rigid internal fixation along with fusion. Motion preservation devices which include both anterior and posterior dynamic stabilization are designed and used especially in the last two decades. This paper evaluates the dynamic stabilization of the lumbar spine and talks about chronologically some novel dynamic stabilization devices and thier efficacies.