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Comparisons of outcomes after single or multilevel dynamic stabilization: effects on adjacent segment
Chi Heon Kim1, Chun Kee Chung, Tae-Ahn Jahng
1Department of Neurosurgery, Seoul National University Hospital, South Korea.
Journal of Spinal Disorders & Techniques
|January 29, 2011
Summary
Dynesys dynamic stabilization offers clinical benefits for degenerative spinal disease but may limit motion and increase stress on adjacent spinal levels, particularly with multiple-level applications. Close monitoring for adjacent segment disease is recommended.
Area of Science:
- Spine surgery
- Orthopedics
- Degenerative spinal disease
Background:
- Dynamic stabilization aims to preserve motion and reduce adjacent segment load compared to rigid fixation.
- Concerns exist regarding Dynesys stiffness and long-term adjacent segment degeneration.
- Limited data is available on risk factors for adjacent segment motion with dynamic stabilization.
Purpose of the Study:
- To compare clinical and radiologic outcomes of Dynesys stabilization.
- To evaluate the effects of Dynesys on adjacent spinal segments.
- To assess differences between single and multiple-level Dynesys stabilization.
Main Methods:
- Retrospective study of 21 patients with degenerative spinal disease treated with Dynesys.
- Clinical outcomes assessed using K-ODI, VAS, and MacNab criteria.
- Radiologic evaluation included whole spine and lumbar spine X-rays (neutral, flexion, extension).
Main Results:
- No significant difference in clinical improvement between single and multiple-level stabilization.
- Postoperative range of motion (ROM) in stabilized segments significantly decreased.
- Increased ROM and retrolisthesis observed in segments above the stabilized levels, especially in multiple-level cases.
Conclusions:
- Dynesys dynamic stabilization is a viable treatment for degenerative spinal disease.
- Limited motion preservation and potential stress on adjacent levels warrant consideration.
- Close monitoring for adjacent segment disease is crucial, particularly after multiple-level stabilization.
