title: Dynamic posterior stabilization for degenerative lumbar spine disease: a large consecutive case series with long-term follow-up by additional postal survey.
abstract: Dynamic stabilization of the degenerated spine was invented to overcome the negative side effects of fusion surgery like adjacent segment degeneration. Amongst various different implants DSS(®) is a pedicle-based dynamic device for stabilizing the spine and preserving motion. Nearly no clinical data of the implant have been reported so far. The current analysis presents results from a single spine surgeon who has been using DSS(®) for the past 5 years and recorded all treatment and outcome data in the international Spine Tango registry.
  
  
  
  From the prospectively documented overall patient pool 436 cases treated with DSS(®) could be identified. The analysis was enhanced with a mailing of COMI patient questionnaires for generating longer-term follow-ups up to 4 years.
  
  
  
  387 patients (189 male, 198 female; mean age 67.3 years) with degenerative lumbar spinal disease including degenerative spondylolisthesis (6.1 %) could be evaluated. The type of degeneration was mainly spinal stenosis (89.9 %). After a mean follow-up of 1.94 years, the COMI score and NRS back and leg pain improved significantly and to a clinically relevant extent. The postoperative trend analysis could not determine a relevant deterioration of these outcomes until 4 years postoperative. 10 patients were revised (2.6 %) and the implant was removed; in most cases, a fusion was performed. Another 5 cases (1.3 %) had an extension of the dynamic stabilization system to the adjacent level. 84.2 % of patients rated that the surgery had helped a lot or had helped.
  
  
  
  The results of this large consecutive series with a follow-up up to 4 years could demonstrate a good and stable clinical outcome after posterior dynamic stabilization with DSS(®). For degenerative diseases of the lumbar spine, this treatment seems to be a valid alternative to fusion surgery.
authors.affiliation: Orthopädische und Neurochirurgische Gemeinschaftspraxis, Eppenreuther Straße 28, 95032, Hof, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Greiner-Perth
authors.affiliation: Regionalspital Emmental AG, Hospital Burgdorf, Oberburgstrasse 54, 3400, Burgdorf, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Sellhast
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Perler
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.|Institute for Mathematical Statistics and Actuarial Science, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Dietrich
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland. lukas.staub@ispm.unibe.ch.
authors.forename: L P
authors.initials: LP
authors.lastname: Staub
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Röder
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D013130:Spinal Stenosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000601:surgery*
keywords: Degenerative spine disease; Dynamic stabilization; Spine Tango