Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years

Yu, Shang-Won; Yen, Cheng-Yo; Wu, Cheng‐Hsien; Kao, Feng-Chen; Kao, Yu-Hsien; Tu, Yuan‐Kun

doi:10.1007/s00402-012-1460-4

Cited by 44 publications

(51 citation statements)

References 30 publications

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“…However in the studies of Yu [20,54] comparing these two systems, obtained a similar percentage of screw loosening with the dynamic system compared with the rigid system, being 14.3% versus 20% of patients, respectively (p=0.728).…”

Section: Discussionmentioning

confidence: 98%

“…In that sense it was expected to nd that the use of the Dynesys system, which unloads the facet joints and intradiscal pressure [58,59], implied a greater decrease of the VAS in back than in legs. Nevertheless, in the studies which compared this data, a greater decrease of the VAS leg pain was found [1,6,20,28,32,33]. is leads us to two possibilities, assuming that the di erent samples of the di erent studies were comparable.…”

Section: Discussionmentioning

confidence: 99%

“…e 8 studies which analyzed the VAS for back and legs obtained di erent results. In one study [4] the decrease was similar, in another study [10] that decrease was greater in the back, and in the last 6 articles [1,6,20,28,32,33] there was a greater decrease in legs than in the back.…”

Section: Patient Related Outcomes By Toolsmentioning

confidence: 99%

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Functional Outcomes after Stabilization with Dynesys in Patients with Spinal Degenerative Diseases

Segura-Trepichio¹,

Wanden-Berghe²,

Sanz-Valero³

et al. 2013

J Spine

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Objective: To know the impact of the Dynesys system on the functional outcomes in patients with spinal degenerative diseases. Summary of background data: Dynesys system has been proposed as an alternative to vertebral fusion for several spinal degenerative diseases. The fact that it has been used in people with different diagnosis criteria using ĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀĀ Methods: The data base of Medlars Online International Literature (MEDLINE) via PubMed © , EMBASE © , and the Cochrane Library Plus were reviewed in search of all the studies published until November 2012 in which an operation with Dynesys in patients with spinal degenerative diseases and an evaluation of the results by an analysis of functional outcomes had taken place. No limits were used to article type, date of publication or language. Results: reviewers. All of them were case series, except for a multicenter randomized clinical trial (RCT) and a prospective case- control study. The selected articles made a total of 1507 cases. The most frequent diagnosis were lumbar spinal canal stenosis (LSCS), degenerative disc disease (DDD), degenerative spondylolisthesis (DS) and lumbar degenerative scoliosis (LDS). In cases of lumbar spinal canal stenosis Dynesys was associated to surgical decompression. Several tools to measure the functional disability and general health status were found. Oswestry Disability Index (ODI), the ODI Korean version (K-Odi), Prolo, Sf-36, Sf-12, Roland-Morris disability questionnaire (RMDQ), and the pain Visual Analogue Scale (VAS) were the most used. They showed positive results in all cases series reviewed. In most studies the ODI decreased about 25% (e.g. from a score of 85% to 60%). Better results when dynamic fusion was combined with nerve root decompression were found. Functional outcomes and leg pain scores with Dynesys were statistically non-inferior to posterolateral spinal fusion using autogenous bone. When Dynesys and decompression was compared Conclusions: In patients with spinal degenerative diseases due to degenerative disc disorders, spinal canal stenosis and degenerative spondylolisthesis, surgery with Dynesys and decompression improves functional outcomes, decreases disability, and reduces back and leg pain. More studies are needed to conclude that dynamic stabilization is better than posterolateral and posterior interbody lumbar fusion. Studies comparing Dynesys with decompression against decompression alone should be done in order to isolate the effect of the dynamic stabilization. Citation: Segura-Trepichio M, Wanden-Berghe C, Sanz-Valero J, Ferrandez- Sempere D, Macia-Soler L (2013) Functional Outcomes after Stabilization with Dynesys in Patients with Spinal Degenerative Diseases. J Spine S2: 002.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Functional Outcomes after Stabilization with Dynesys in Patients with Spinal Degenerative Diseases

Segura-Trepichio¹,

Wanden-Berghe²,

Sanz-Valero³

et al. 2013

J Spine

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“…New technologies have been developed to stabilize the functional spinal unit because of the proven disadvantages of spinal fusion, including pseudoarthrosis, nonunion, instrumentation failure, restriction of the spinal range of motion, adjacent segment disease, infection, and donor site pain (5,14,18). The newly developed dynamic spinal stabilization systems have aimed to stabilize the operated segment while preserving motion (3,26).…”

Section: Djurasovic Et Al Investigated Which Mri Findings In Patientsmentioning

confidence: 99%

Effect of posterior dynamic instrumentation on high-intensity zones in lumbar degenerative disc disease

Canbay

Ataker²,

Canbulat³

et al. 2015

Turkish Neurosurgery

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AIm: To investigate high-intensity zone (HIZ) changes after lumbar posterior dynamic instrumentation. mATeRIAL and meTHods: Our study included 53 patients: 27 patients in group 1, 26 patients in group 2. All patients had one or two levels of degenerative disc disease with an HIZ confirmed by magnetic resonance imaging (MRI). Group 1 underwent one-or two-level dynamic lumbar posterior instrumentation. Group 2 was treated conservatively with an exercise program. Patients were evaluated using MRI, a numerical visual analog pain scale (VAS), and the Oswestry Disability Index (ODI) at baseline, at 1 year after surgery, and at final follow-up evaluation. ResuLTs:The mean duration of follow-up was 49.3 months in group 1 and 47.19 months in group 2. The baseline VAS and ODI scores were similar for both groups. The mean VAS score of group 1 was significantly improved at 1 year after surgery and at final follow-up. The mean ODI value was lower in group 1 than in group 2 at 1 year and at final follow-up. Pfirrmann grades in group 1 significantly differed at 1 year and at final follow-up but did not change in group 2. The number of HIZs significantly decreased in from baseline to 1 year and from baseline to final follow-up in group 1 but did not differ in group 2.CoNCLusIoN: Dynamic lumbar stabilization systems are promising. Observations such as Pfirrmann grade improvements and disappearance of HIZs are concordant with improvements in VAS and ODI scores demonstrate that dynamic stabilization systems may provide an environment for regeneration.

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“…Despite the reported benefits of fusion surgery, many complications can occur. These complications include instrumentation failure, pseudarthrosis and loss of motion [1]. Additionally, the accelerated degeneration of spinal motion segments that are adjacent to a rigidly fused segment has become increasingly recognized as a disadvantage of spinal fusion surgery.…”

Section: Introductionmentioning

confidence: 98%

Minimum 5year follow-up of multi-segmental lumbar degenerative disease treated with discectomy and the Wallis interspinous device

Jiang

Che

Wang

et al. 2015

Journal of Clinical Neuroscience

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Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years

Abstract: In conclusion, Dynesys is an acceptable alternative to PLIF for the treatment of multisegment lumbar disease.

Cited by 44 publications

References 30 publications

Functional Outcomes after Stabilization with Dynesys in Patients with Spinal Degenerative Diseases

Functional Outcomes after Stabilization with Dynesys in Patients with Spinal Degenerative Diseases

Effect of posterior dynamic instrumentation on high-intensity zones in lumbar degenerative disc disease

Minimum 5year follow-up of multi-segmental lumbar degenerative disease treated with discectomy and the Wallis interspinous device

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