Artikel
Early aseptic failure of the dynamic stabilisation system
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Autoren
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C. McLean
- Dept Orthopaedic & Trauma Surgery, Frimley Park Hospital, Surrey, UK, Orthopaedics, Frimley, Surrey
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P. Patel
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C. Sullivan
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M. Thomas
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S. Chatakondu
| Veröffentlicht: | 13. Juni 2005 |
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Gliederung
Text
Introduction
The Dynamic Stabilisation System (Dynesys) has been used in the treatment of spinal stenosis for the past ten years. Our institution has been using the implant for eighteen months. In the short term we have observed some good results, however, we have experienced four major complications.
Methods
Since January 2003 we have performed forty-five Dynesys stabilisations. We have not yet formally analysed our surgical outcomes. Nevertheless as the Dynesys is a new implant in our centre we have, in the interests of clinical governance, recorded any complications we have observed.
Results
Of the forty-five cases we have performed there have been four aseptic failures. One failure occurred during surgery and came to light in the immediate post-operative period. In this case a pedicle screw was medially misplaced and caused immediate, nerve root impingement. Following an urgent computerised tomography scan, the patient was re-operated on, the misplaced screw was removed and the Dynesys trimmed. The three remaining cases have resulted in worsening of their pre-operative symptoms, and have been associated with loosening of some of the pedicle screws. Two of these patients have had further surgery, whilst the third is awaiting operation, one patient had a loose screw removed and the Dynesys trimmed resulting in good pain relief; the other required removal of the entire implant with some clinical improvement.
Conclusion
Early aseptic failure of the Dynesys can occur, and may reflect a 'learning curve phenomenon'.
