Dysfunctional Segmental Motion Treated with Dynamic Stabilization in the Lumbar Spine

• Published in: World neurosurgery 2011-05, Vol.75 (5), p.743-749
• Main Authors: Cansever, Tufan, Civelek, Erdinç, Kabatas, Serdar, Yılmaz, Cem, Caner, Hakan, Altinörs, M. Nur
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Bone Nails; Decompression, Surgical; Degenerative disc disease; Dynamic; Dysfunctional segmental motion; Female; Follow-Up Studies; Humans; Internal Fixators; Intervertebral Disc - pathology; Lordosis - pathology; Lumbar; Lumbar Vertebrae - surgery; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Movement - physiology; Movement Disorders - diagnostic imaging; Movement Disorders - pathology; Movement Disorders - surgery; Neurosurgery; Radiography; Retrospective Studies; Spondylolisthesis - diagnostic imaging; Spondylolisthesis - pathology; Spondylolisthesis - surgery; Stabilization; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2010.12.004

Objective To determine the suitability of the application of dynamic stabilization (DS) as a nonfusion technique to address dysfunctional segmental motion (DSM) in the lumbar spine. Methods Over a 1-year period, 25 patients were treated with the same assessment and surgical protocol. Inclusion criteria were clinical presentation of DSM with or without stenosis. On preoperative and postoperative plain anteroposterior, lateral, and lateral flexion-extension radiographs, anterior and posterior disc height (DH); anteroposterior diameter of the disc; and global, segmental, apical segment, and below level lordotic angles (LAs) were measured. Results The study included 9 women and 16 men with a mean age of 43.48 years ± 7.6. On average, patients had symptoms for 38.04 months ± 29.6, and mean follow-up was 12.36 months ± 3.46. The average height of anterior, posterior, and mean intervertebral discs increased significantly ( P = 0.002, P = 0.003, and P < 0.0001). There were no significant differences between the preoperative and postoperative global, segmental, apical segment, and below segment LAs in flexion, extension, and neutral positions. At mid-term follow-up, no patients showed new signs of degeneration at the adjacent motion segment. Conclusions Overall, the limited radiologic data advocate DS as a nonfusion technique in the treatment of DSM in the lumbar spine. Long-term follow-up is essential, however, to investigate the long-term efficacy of DS in the surgical treatment of DSM.