title: Clinical experiences of dynamic stabilizers: Dynesys and Dynesys top loading system for lumbar spine degenerative disease.
abstract: Dynesys (Dynamic Neutralization System) was designed to overcome the shortcomings of fusion. The Dynesys top loading (DTL) system is a new alternative Dynesys system that can be applied via a minimally invasive procedure. This study aimed to ascertain whether DTL is a suitable device for motion preservation and prevention of instability, and to compare the clinical and radiological outcomes between DTL and Dynesys. In this study, 12 patients were treated with Dynesys and 21 patients were treated with DTL. Back and leg pain were evaluated using the visual analog scale. The Oswestry Disability Index was used to evaluate the patients' function. Range of motion (ROM) at the operative level and for the whole lumbar spine was measured pre- and postoperatively. The length of wound, blood loss, length of hospital stay, and operation duration were also compared. All patients were followed up for 12-76 months. Scores on the visual analog scale and Oswestry Disability Index were significantly improved postoperatively. The median ROM of the whole spine and index level ROM in all patients showed 12.5% and 79.6% loss, respectively. The DTL group exhibited significantly better results in terms of blood loss, wound length, and operation duration, in addition to early ambulation. In conclusion, Dynesys and DTL are semirigid fixation systems that can significantly improve clinical symptoms and signs. Our results suggested that DTL was better than Dynesys as a result of it being a minimally invasive procedure. However, further study with large sample sizes and longer follow-up durations is required to validate the effects of these dynamic stabilizers.
authors.affiliation: Department of Neurosurgery, Cathay General Hospital, Taipei City, Taiwan; Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Cheng-Ta
authors.initials: CT
authors.lastname: Hsieh
authors.affiliation: Department of Neurosurgery, Cathay General Hospital, Taipei City, Taiwan; Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan. Electronic address: miklechang5639@gmail.com.
authors.forename: Chih-Ju
authors.initials: CJ
authors.lastname: Chang
authors.affiliation: Department of Neurosurgery, Cathay General Hospital, Taipei City, Taiwan; Department of Medicine, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Su
authors.affiliation: Department of Surgery, Cathay General Hospital, Taipei City, Taiwan.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Lin
mesh_terms: D000328:Adult; D003710:Demography; D005260:Female; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D019919:Prosthesis Implantation; D016059:Range of Motion, Articular; D013123:Spinal Fusion
keywords: DTL; Dynamic stabilizer; Dynesys; Lumbar spondylosis