title: Dynamic stabilization versus fusion for treatment of degenerative spine conditions.
abstract: METHODS
  Comparative effectiveness review.
  
  
  OBJECTIVE
  Spinal fusion is believed to accelerate the degeneration of the vertebral segment above or below the fusion site, a condition called adjacent segment disease (ASD). The premise of dynamic stabilization is that motion preservation allows for less loading on the discs and facet joints at the adjacent, non-fused segments. In theory, this should decrease the rate of ASD. However, clinical evidence of this theoretical decrease in ASD is still lacking. We performed a systematic review to evaluate the evidence in the literature comparing dynamic stabilization with fusion.
  
  
  OBJECTIVE
  In patients 18 years or older with degenerative disease of the cervical or lumbar spine, does dynamic stabilization lead to better outcomes and fewer complications, including ASD, than fusion in the short-term and the long-term?
  
  
  METHODS
  A systematic search and review of the literature was undertaken to identify studies published through March 7, 2011. PubMed, Cochrane, and National Guideline Clearinghouse Databases as well as bibliographies of key articles were searched. Two individuals independently reviewed articles based on inclusion and exclusion criteria which were set a priori. Each article was evaluated using a predefined quality-rating scheme.
  
  
  RESULTS
  No significant differences were identified between fusion and dynamic stabilization with regard to VAS, ODI, complications, and reoperations. There are no long-term data available to show whether dynamic stabilization decreases the rate of ASD.
  
  
  CONCLUSIONS
  There are no clinical data from comparative studies supporting the use of dynamic stabilization devices over standard fusion techniques.
authors.affiliation: University of California, San Francisco, California, USA.
authors.forename: Dean
authors.initials: D
authors.lastname: Chou
authors.forename: Darryl
authors.initials: D
authors.lastname: Lau
authors.forename: Andrea
authors.initials: A
authors.lastname: Skelly
authors.forename: Erika
authors.initials: E
authors.lastname: Ecker