[Pedicular dynamic stabilization system. Functional outcomes and implant-related complications for the treatment of degenerative lumbar disc disease with a minimum follow-up of 4 years].
BACKGROUND
The Dynesys(®) system is a non-fusion pedicular dynamic stabilization system. The aim of our study is to evaluate the clinical outcomes in patients with degenerative disc disease and/or stenosis, and to measure the prevalence of screw loosening and breakage after 4 years of follow up.


METHODS
All patients who underwent surgery with Dynesys(®) system in 2008 were reviewed. The surgery was performed in cases of low back pain of more than 6 months duration and a positive MRI for degenerative disc disease and/or stenosis.


RESULTS
A total of 22 patients (11 females, 11 males) with a mean age of 44.40 ± 11 years were included, 20 patients (91%) underwent Dynesys(®) without any associated decompression maneuver. The evaluation of back and leg pain (0-10mm) showed a mean decrease of 2.4 ± 2.06 mm (P=.0001). The preoperative value of the Oswestry disability index was 52.36 ± 16.56% (severe functional limitation). After surgery, this value was 34.27 ± 17.87% (moderate functional limitation) (P=.001) with a decrease of 18.09 ± 16.03% (P=.001). A total of 4 (18%) patients showed signs of loosening screws. One patient (4.5%) had a screw breakage.


CONCLUSIONS
Surgery with Dynesys(®) shows favorable long term clinical results, however the range of improvement in our series is lower than those reported in other studies. Comparative studies between Dynesys(®) and decompression need to be performed in order to isolate the benefit of the dynamic stabilization system. Implant-related complications are not uncommon.
Departamento de Cirugía Ortopédica y Traumatología, Hospital General Universitario de Elche, Elche, Alicante, España. Electronic address: manusegura5@gmail.com.
M
M
Segura-Trepichio
Departamento de Neurocirugía, Hospital General Universitario de Elche, Elche, Alicante, España.
D
D
Ferrández-Sempere
Departamento de Cirugía Ortopédica y Traumatología, Hospital General Universitario de Elche, Elche, Alicante, España.
F
F
López-Prats
Departamento de Neurocirugía, Hospital General Universitario de Elche, Elche, Alicante, España.
J
J
Segura-Ibáñez
Departamento de Ciencias de la Salud, Universidad Jaume I de Castellón, Castellón de la Plana, España.
L
L
Maciá-Soler
D000328:Adult; D001863:Bone Screws / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000601:surgery*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
Aflojamiento de tornillos; Degenerative disc disease; Enfermedad degenerativa discal; Estenosis de canal lumbar; Functional outcomes; Lumbar stenosis; Pedicular dynamic stabilization system; Resultados funcionales; Screw loosening; Sistema de estabilización dinámica