The influence of L4–S1 Dynesys® dynamic stabilization versus fusion on lumbar motion and its relationship with lumbar degeneration: a retrospective studyReport as inadecuate




The influence of L4–S1 Dynesys® dynamic stabilization versus fusion on lumbar motion and its relationship with lumbar degeneration: a retrospective study - Download this document for free, or read online. Document in PDF available to download.

Journal of Orthopaedic Surgery and Research

, 12:99

First Online: 26 June 2017Received: 31 January 2017Accepted: 16 June 2017

Abstract

BackgroundThe aim of this study is to evaluate the efficacy of Dynesys® posterior dynamic stabilization PDS in the treatment of L4–S1 degenerative diseases and to assess the influence of postoperative motion on lumbar degeneration.

MethodsIncluded in this retrospective study were patients with L4–S1 degenerative disease who underwent fusion or PDS from September 2010 to September 2014. Clinical outcomes were assessed by preoperative and postoperative visual analog scale VAS and Oswestry Disability Index ODI. Preoperative and postoperative X-rays assessed range of motion ROM of the non-surgical and surgical levels and whole lumbar. MRI assessed degeneration of non-surgical levels.

ResultsA total of 56 consecutive patients were divided into two groups: group A, PDS, and group B, fusion. Patient demographics and baseline characteristics were similar in the two groups. In both groups, there was a significant difference between preoperative and postoperative VAS and ODI scores P < 0.05. However, there was a significant difference in a 6-month follow-up ODI between the two groups P < 0.05. X-rays showed PDS patients partially maintained surgical level ROM and non-surgical level ROM increased less than in the fusion group. MRI showed adjacent segment degeneration ASD in both groups, and patients whose preoperative L3–4 Pfirrmann classification was higher than grade 2 had more ASD than lower than grade 2.

ConclusionPDS can maintain surgical level ROM and had less influence on whole and non-surgical level ROM. Following PDS, patients recovered faster and had a better lumbar function. It may be a better choice for multi-level lumbar degenerative diseases.

KeywordsPosterior dynamic stabilization L4–S1 Lumbar degenerative diseases Range of motion Adjacent segment degeneration AbbreviationsAIDSAcquired immune deficiency syndrome

ASDAdjacent segment degeneration

DXADual-energy X-ray absorptiometry

MRIMagnetic resonance imaging

ODIOswestry Disability Index

PACSPicture archiving and communication system

PDSPosterior dynamic stabilization

ROMRange of motion

TLIFTransforaminal lumbar interbody fusion

VASVisual analog scale

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Author: Chengmin Zhang - Liyuan Wang - Tianyong Hou - Lei Luo - Chen Zhao - Yibo Gan - Qiang Zhou - Pei Li

Source: https://link.springer.com/



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