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Segment-by-segment stabilization for degenerative disc disease: a hybrid technique.

Othmar Schwarzenbach¹, Nathalie Rohrbach, Ulrich Berlemann

¹Das Rückenzentrum, Bahnhofstrasse 3, 3600, Thun, Switzerland. o.schwarzenbach@dasRueckenzentrum.ch

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

|February 5, 2010

Summary

This study shows that combining Dynesys non-fusion implants with posterior lumbar interbody fusion (PLIF) for multisegmental degenerative disc disease (DDD) significantly reduces pain and disability. This segment-by-segment approach is safe and effective for treating multilevel DDD.

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Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability

Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability

Published on: July 25, 2025

Area of Science:

Spine surgery
Orthopedics
Neurosurgery

Background:

Multisegmental degenerative disc disease (DDD) poses treatment challenges.
Surgical options include fusion and non-fusion techniques.
Segment-by-segment application of implants offers a novel approach.

Purpose of the Study:

To evaluate the clinical and radiological outcomes of a segment-by-segment surgical technique for multilevel DDD.
To assess the combined use of Dynesys non-fusion implants and posterior lumbar interbody fusion (PLIF).

Main Methods:

A consecutive case series of 31 patients (16 female, 15 male) with a mean age of 53.6 years.
Patients underwent segment-by-segment treatment using Dynesys implants (non-fusion) and PLIF (fusion).
Clinical outcomes (Oswestry disability index, VAS pain scores) and radiological outcomes (fusion success, system failure) were assessed over a mean follow-up of 39 months.

Main Results:

Significant improvements were observed in back pain (7.3 to 3.4), leg pain (6.0 to 2.3), and Oswestry disability index (51.6% to 28.7%).
A very low rate of screw loosening (0.45%) was reported.
The technique demonstrated high fusion success and no system failures.

Conclusions:

Segment-by-segment treatment combining Dynesys non-fusion and PLIF fusion is technically feasible.
This combined approach is safe and effective for surgical treatment of multilevel degenerative disc disease.
The study supports this hybrid technique for managing complex DDD cases.