Dynesys dynamic neutralization system for the treatment of lumbar degenerative disease and the effect on the adjacent segment

doi:R318

Abstract

Abstract:

BACKGROUND: Numerous studies show Dynesys dynamic neutralization system has achieved good clinical efficacy in the treatment of lumbar degenerative disease. But whether Dynesys dynamic neutralization system can prevent the adjacent segment degenerative disease is still controversial.
OBJECTIVE: To investigate the efficacy of the Dynesys system for the treatment of lumbar degenerative disease and impact on adjacent segments.
METHODS: From March 2009 to October 2012, 20 consecutive patients with lumbar degenerative disease were included in this study. All the patients were treated with surgical decompression plus Dynesys system dynamic fixation. The Dynesys system was provided by Zimmer Company, and composed with titanium alloy pedicle screws, polyurethane sleeve and polyethylene terephthalate rope. Clinical outcomes were evaluated using visual analogue scale and Oswestry disability index before and after operation. The degeneration of the adjacent segment was evaluated according to Woodend score; the treatment efficiency was assessed with Macnab criteria.
RESULTS AND CONCLUSION: All the 20 patients were followed-up for 22-31 months. According to Macnab criteria, excellent in 11 cases, good in six cases, fair in three cases, and the excellent and good rate was 83%. The visual analogue scale score was decreased from preoperative (8.29±1.50) to postoperative (2.25±1.67) (P < 0.01), and the Oswestry disability index score was improved from (65.46±10.33) to (15.38±3.42) (P < 0.01). Mean Woodend score of adjacent segment degeneration was increased from 1.33 preoperatively to 1.60 postoperatively, and the difference was significant (P > 0.05). This study shows Dynesys system is safe and effective in the treatment of lumbar degenerative diseases and multi-center randomized controlled clinical trials are needed to identify whether it can reduce or prevent the occurrence of disc degeneration of adjacent segments.

Key words: bone and joint implants, spinal implants, Dynesys system, dynamic stabilization, lumbar degenerative disease, lumbar spinal stenosis, adjacent segments, degeneration, Macnab criteria, visual analog scale, Oswestry disability index, Woodend score, provincial grants-supported paper

CLC Number:

10.3969/j.issn.2095-4344.2013.17.003

Yang Bo, Wan Sheng-yu, Zeng Mian-dong, Lü Yu-ming, Fang Shi-bing, Xie Jing-kai. Dynesys dynamic neutralization system for the treatment of lumbar degenerative disease and the effect on the adjacent segment[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(17): 3057-3064.

Figures/Tables 4

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