[Application of a dynamic pedicle screw system (DYNESYS) for lumbar segmental degenerations - comparison of clinical and radiological results for different indications].
OBJECTIVE
Evaluation of the efficacy of a dynamic stabilizing system for different indications using medium-term clinical and radiological parameters.


METHODS
Out of a total of 70 evaluated patients, 35 showed initial disc degeneration and disc herniation (group 1). In this group, additional nucleotomy was performed. Group 2 included 22 patients with initial osteochondrosis and facet joint osteoarthritis. 13 patients suffered from progressive segment degeneration or degenerative spondylolisthesis (group 3). Clinical evaluation was performed preoperatively, three months postoperatively and at follow-up (33 months). Examinations included subjective and objective measures using the Oswestry Index and VAS as well as radiographs and MRI.


RESULTS
Oswestry Index and VAS improved significantly in groups 1 and 2 and remained improved until follow-up. Group 3 showed no significant changes. The evaluation of radiographs and MRI of groups 1 and 2 revealed no progression of the degeneration either at the operated segments or at the adjacent segments. In group 3, 9 cases of progressive degeneration of the operated segments and 3 cases of adjacent segment degeneration were found. Out of 5 implant-associated complications 4 were observed in group 3.


CONCLUSIONS
Dynesys is able to compensate initial morphological changes and to prevent progression of segment degeneration. The system seems not to be indicated for treating marked deformities or if osseous decompression needs to be performed.
Putzier
M
M
Orthopädische Universitätsklinik und Poliklinik, Medizinische Fakultät der Humboldt-Universität zu Berlin, Campus Charité Mitte. michael.putzier@charite.de
Schneider
S V
SV
Funk
J
J
Perka
C
C
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D001863:Bone Screws; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome