Can posterior dynamic stabilization reduce the risk of adjacent segment deterioration?

Area of Science:

• Spine surgery
• Biomechanical engineering
• Orthopedics

Background:

• Adjacent segment degeneration (ASDeg) and adjacent segment disease (ASDis) are potential complications following spinal fusion.
• Posterior dynamic stabilization (PDS) is an alternative surgical technique aiming to mitigate these risks.

Purpose of the Study:

• To establish a benchmark incidence for ASDeg and ASDis after PDS.
• To compare the efficacy of isolated PDS versus fusion in preventing ASDeg and ASDis.
• To evaluate the protective role of additional PDS devices adjacent to fusion.

Main Methods:

• Systematic literature review of Medline, Ovid, and Cochrane Central Registry.
• Inclusion of 31 relevant articles.
• Pooled incidence calculation and comparative analysis of PDS versus fusion.

Main Results:

• Pooled incidence of ASDeg and ASDis following PDS was 16.4% and 5.5%, respectively.
• PDS demonstrated a significantly lower incidence of ASDeg and a nonsignificantly lower incidence of ASDis compared to fusion.
• Additional PDS devices adjacent to fusion significantly reduced ASDeg and nonsignificantly decreased ASDis.

Conclusions:

• The PDS procedure shows relative success in preventing ASDeg and ASDis.
• PDS may be a viable alternative to fusion for reducing adjacent segment complications.
• The use of PDS in conjunction with fusion warrants further investigation for its protective effects.