Posterior dynamic stabilization for the treatment of patients with lumbar degenerative disc disease: long-term clinical and radiological results

Abstract

AIm:Comparison of long-term preoperative and postoperative clinical and radiological results for patients diagnosed with degenerative disc disease that underwent posterior dynamic stabilization. Lumbar disc degeneration is caused by a variety of factors. Disruptions in the vertebral endplate result in defects in disc nutrition and, thus, disc degeneration. The aims of dynamic stabilization are to unload the disc/facet joints, preserve motion under mechanical load, and restrict abnormal motion in the spinal segment. mAterIAl and methOds: Twenty-five patients diagnosed with lumbar degenerative disc disease were enrolled. Totally, 25 vertebral segments were subjected to posterior dynamic stabilization. Patients were clinically evaluated in the preoperative and postoperative periods using the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS). Segmental movement was evaluated radiologically in the late postoperative period by measuring the segmental angles during flexion and extension.results: Significant postoperative improvements were observed in the ODI and VAS measurements (P<0.01). During the long postoperative period (averaging 5 years and 2 months), lumbar lordosis angles, intervertebral space ratio and segmental ratio were measured and compared statistically. Adjacent segment disease developed in two patients. Both patients received L5-S1 discectomy.COnClusIOn: Good clinical outcomes were observed in the treatment of lumbar degenerative disc disease with a posterior dynamic system. KeywOrds: Degenerative disc disease, Dynamic stabilization, Lumbar spine, Surgical treatment ÖZ AmAÇ: Dejeneratif disk hastalığı tanısı almış ve posterior dinamik stabilizasyon sistemi uygulanmış hastaların uzun dönem preoperatif ve postoperatif klinik ve radyolojik sonuçlarının karşılaştırılması. Lomber dejeneratif disk hastalığına birçok etken sebep olur. Bu etkenler sonuç olarak omurga son plaklarında dejenerasyona ve disk dokusunun beslenmesinin bozulmasına yol açar. Dinamik stabilizasyon sistemleri, omurlar arasındaki hareketi korurken, disk ve faset eklemleri üzerindeki aşırı yüklenmeyi azaltır, aynı zamanda da omurga segmentindeki anormal hareketlenmeyi önler. yÖntem ve GereÇler: Bu çalışmada, dejeneratif disk hastalığı tanısı konmuş 25 hasta ele alınmıştır. Toplamda 25 omurga segmentine posterior dinamik stabilizasyon uygulanmıştır. Hastalar, preoperatif ve postoperatif dönemde Oswestry Disability Index (ODI) and Vizüel Analog Skala (VAS) ile klinik olarak değerlendirilmiştir. Segmental hareketi değerlendirmek için geç postoperatif dönemde radyolojik olarak fleksiyon ve ekstansiyon grafileri kullanılmıştır.BulGulAr: Postoperatif dönemde ODI ve VAS ölçümlerinde anlamlı düzelmeler kaydedilmiştir (P<0,01). Ameliyatlardan sonraki uzun dönem takiplerinde (ortalama 5 yıl 2 ay), lomber lordoz açısı, intervertebral aralık oranı ve segmental oran ölçülmüş ve istatiksel olarak değerlendirilmiştir. İki hastada postoperatif dönemde komşu segment hastalığı tespit edilmiş ve bu hastalarda L5-S1 diskektomi uygulanmışt...

Short term outcome of posterior dynamic stabilization system in degenerative lumbar diseases

“…Many studies 24 29 30 31 32 33 34 have reported positive results of the Dynesys, while some reports have indicated that results are no better than those obtained with typical fusion. Haddad et al .…”

Dynamic radiographic results of different semi-rigid lumbar fusion devices for degenerative lumbar spondylolisthesis: &#8220;dynamic rod&#8221; vs. &#8220;dynamic screw head&#8221;

“…Therefore, we used dynamic plain radiographs to evaluate the ROM of lumbar vertebral segments. The preliminary results of a few studies conducted on this system found that the Cosmic dynamic stabilization system did not influence adjacent segment motion and improved clinical symptoms (3,17).…”

“…Similar to the BioFlex system, the Dynesys system (dynamic rod-rigid screw device, Zimmer spine Inc., Warsaw, IN) may be generally used for the treatment of lumbar degenerative disorders with many clinical results (10,18); the BioFlex system (dynamic rod-rigid screw device, Biospine Corp., Seoul, Korea) was also proven to be a useful device for dynamic stabilization (9,21). Some investigators have reported good clinical and radiologic outcomes of the BioFlex dynamic stabilization system using dynamic plain x-ray films (3,9,21).…”