title: Complications associated with the Dynesys dynamic stabilization system: a comprehensive review of the literature.
abstract: The Dynesys dynamic stabilization system is an alternative to rigid instrumentation and fusion for the treatment of lumbar degenerative disease. Although many outcomes studies have shown good results, currently lacking is a comprehensive report on complications associated with this system, especially in terms of how it compares with reported complication rates of fusion. For the present study, the authors reviewed the literature to find all studies involving the Dynesys dynamic stabilization system that reported complications or adverse events. Twenty-one studies were included for a total of 1166 patients with a mean age of 55.5 years (range 39-71 years) and a mean follow-up period of 33.7 months (range 12.0-81.6 months). Analysis of these studies demonstrated a surgical-site infection rate of 4.3%, pedicle screw loosening rate of 11.7%, pedicle screw fracture rate of 1.6%, and adjacent-segment disease (ASD) rate of 7.0%. Of studies reporting revision surgeries, 11.3% of patients underwent a reoperation. Of patients who developed ASD, 40.6% underwent a reoperation for treatment. The Dynesys dynamic stabilization system appears to have a fairly similar complication-rate profile compared with published literature on lumbar fusion, and is associated with a slightly lower incidence of ASD.
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Pham
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Vivek A
authors.initials: VA
authors.lastname: Mehta
authors.affiliation: Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Neil N
authors.initials: NN
authors.lastname: Patel
authors.affiliation: Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Andre M
authors.initials: AM
authors.lastname: Jakoi
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Hsieh
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: John C
authors.initials: JC
authors.lastname: Liu
authors.affiliation: Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Wang
authors.affiliation: Departments of 1 Neurosurgery and.
authors.forename: Frank L
authors.initials: FL
authors.lastname: Acosta
mesh_terms: D000818:Animals; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery; D019635:Neurosurgical Procedures / Q000009:adverse effects* / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D012086:Reoperation / Q000009:adverse effects / Q000639:trends*; D013122:Spinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000639:trends; D016896:Treatment Outcome
keywords: ASD = adjacent-segment disease; ASP = adjacent-segment pathology; Dynesys; adjacent-segment disease; complications; infection; reoperation; screw fracture; screw loosening