gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Stabilizing the degenerative lumbar spine by a dynamic neutralization system : indication and results in 40 patients

Stabilisierung der degenerativen Lendenwirbelsäule mit einem dynamischen Fixateur : Indikation und Ergebnisse bei 40 Patienten

Meeting Abstract

Suche in Medline nach

  • A. Afsah - Neurosurgical Department, HSK Dr. Horst-Schmidt-Kliniken Wiesbaden
  • corresponding author M. J. Melzer - Neurosurgical Department, HSK Dr. Horst-Schmidt-Kliniken Wiesbaden
  • R. Schönmayr - Neurosurgical Department, HSK Dr. Horst-Schmidt-Kliniken Wiesbaden

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-11.06

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0051.shtml

Veröffentlicht: 4. Mai 2005

© 2005 Afsah et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Treating lumbar segmental instability with various rigid fusion techniques is a common procedure. Despite obtaining bony fusion, the clinical outcome is not always satisfying. Compensatory loadsharing may result in progressive instability of neighbouring segments. Dynamic segmental restabilization is an alternative method. We report our experience using a dynamic system for segmental stabilization (DYNESYS®). Clinical and radiological results have been evaluated.

Methods

In 4 years, 40 patients (female/male: 21/19) were treated by DYNESYS® instrumentation for segmental restabilization (1/2/3/4 level(s): 22/14/3/1 case(s)). In special indications (8) an additional monosegmental interbody fusion (PLIF) was used in combined multilevel procedures. Other indications were: degenerative instability with stenosis (24); additional monosegmental spondylolisthesis (4); failed back surgery syndrome (4). Oswestry-low-back-pain and Kaneda-scores were used for clinical follow-up. Plain, flexion-extension X-rays, CT and/or MRI, and in some cases flexion-extension open MRI were employed for radiological evaluation.

Results

According to clinical scores 33 patients had good or excellent outcomes; in 7 patients no benefit was achieved. In 3 cases malposition of pedicular screws caused poor outcome, in 1 case implant failure resulted in revision with PLIF procedure. In all other cases a permanent stabilization of segmental motion could be observed.

Conclusions

Dynamic transpedicular stabilization is a new competitive method of treatment for degenerative diseases of the lumbar spine. It provides immediate stabilization with controlled range of motion in hyper- or hypomobile degenerated segments. The clinical results are promising. Long-term follow-up is necessary.