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69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

03.06. - 06.06.2018, Münster

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Re-operation rates and risk factors at a minimum of 4-Year Follow Up after dynamic lumbar stabilization using a semirigid system

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  • Sandro Krieg - Technische Universität München, Klinikum rechts der Isar, München, Deutschland
  • Anna Rienmüller - Technische Universität München, Klinikum rechts der Isar, München, Deutschland
  • Franziska Schmidt - Technische Universität München, Klinikum rechts der Isar, München, Deutschland
  • Bernhard Meyer - Technische Universität München, Klinikum rechts der Isar, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie. Münster, 03.-06.06.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocV216

doi: 10.3205/18dgnc220, urn:nbn:de:0183-18dgnc2207

Published: June 18, 2018

© 2018 Krieg et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The concept of dynamic stabilization (DS) of the lumbar spine for treatment of degenerative instability has been introduced more than one decade ago. DS follows the principle of controlling movement in the coronal plane by providing load transfer of the spinal segment without fusion. So far only little is known about the long term revision and ASD rates after DS.

Methods: We retrospectively assessed 215 (119 females/96 males) consecutively operated patients who underwent DS of the lumbar spine between January 2008 and December 2010 we analyzed the longitudinal re-operation rate due to ASD, SL, and implant failure. Risk factors such as age, gender, lumbar lordosis, as well as number of stabilized segments were taken into consideration for prediction of revision using a mixed model logistic regression.

Results: Mean age was 65.7 years (range 31-88). 97 patients were stabilized in 1 segment, 102 in 2, 14 in 3, and 2 patients in 4 segments. Reoperation rate after 1 year was 6%, after 2 years 14%, and after the mean follow-up of 58 ± 12 months 20.9%, respectively. Reason for revision was SL in 5,5%, ASD in 10% cases and SL and ASD in 3,7% cases, mechanical failure in 1,3% and infection in 0,4% case. Age [OR 0.96, p<0.005] and the number of stabilized segments [OR1.68, p=0.01] had a significant influence on the probability for revision surgery.

Conclusion: Re-operation rates after DS of the lumbar spine are comparable to rigid fixations. The younger the patient and the more segments are involved, the higher was the risk for revision. Having these factors in mind, DS seems to be a valid option for degenerative instability.