[Pedicle screw-based systems for dynamic stabilization : An insight into the philosophy, technique, indications and...

Pedicle screw-based dorsal dynamic systems for segmental stabilization of the lumbar spine are an addition to established surgical methods. They differ in terms of their kinetics as well as their materials. The long-term load on these systems is much higher than in spondylodesis systems, which can only successfully bear loads until bone fusion; cases of implant failure and screw loosening are not rare.Pedicle screw-based systems represent a therapeutic option when conservative treatment proves unsuccessful and fusion seems to be too early. Finding the correct indication versus that of established methods is complex given our limited knowledge to date; symptomatic segments with moderate degenerative changes in facet joints and disc height, as well as Modic 2-3 signs seem to be appropriate cases. The same is true of segments adjacent to planned fusions. Dynamic stabilization can be considered in the case of long fusion, cranial location in the lumbar spine and high likelihood of instability and deformity.