Dynamic constructs for spinal fusion: an evidence-based review.
Dynamic stabilization of the spine has applications in cervical and lumbar degenerative disease and in thoracolumbar trauma. There is little evidence to support the use of dynamic cervical plates rather than rigid anterior cervical fixation. Evidence to support the use of dynamic constructs for fusion in the lumbar spine is also limited. Fusion rates, implant loosening, and failure are significant concerns that limit the adoption of current devices. This article provides a synopsis of the literature on human subjects. There is a need for high-quality evidence for interventions for spinal pathology. An evidence-based approach to the management of spinal disorders will require ongoing assessment of clinical outcomes and comparison of effectiveness between alternatives.
Kelly
Michael P
MP
Department of Orthopaedic Surgery, University of California, 500 Parnassus Avenue, MU 320-W, San Francisco, CA 94110, USA. kellym@orthosurg.ucsf.edu
Mok
James M
JM
Berven
Sigurd
S
D001577:Benzophenones; D001672:Biocompatible Materials / Q000627:therapeutic use; D001860:Bone Plates; D004867:Equipment Design; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D007659:Ketones / Q000627:therapeutic use; D008159:Lumbar Vertebrae; D009984:Orthopedic Fixation Devices; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011108:Polymers; D011475:Prosthesis Failure; D013123:Spinal Fusion / Q000295:instrumentation
D001577:Benzophenones; D001672:Biocompatible Materials; D007659:Ketones; D011108:Polymers; C063834:polyetheretherketone; D011092:Polyethylene Glycols