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Long-term Outcome After Monosegmental L4/5 Stabilization for Degenerative Spondylolisthesis With the Dynesys Device
Sven Hoppe1, Othmar Schwarzenbach, Emin Aghayev
1*Das Rückenzentrum, Spinal Surgery, Thun†Department of Orthopaedic Surgery, University of Bern, Inselspital‡MEM Research Center, Bern§Department of Radiology, University of Bern, Inselspital, Bern, Switzerland.
Clinical Spine Surgery
|February 19, 2016
Summary
Long-term outcomes for L4/5 degenerative spondylolisthesis treated with Dynesys instrumentation show high patient satisfaction and pain improvement. Secondary surgery rates are comparable to other devices, with low adjacent segment degeneration.
Area of Science:
- Spine surgery
- Orthopedic technology
- Degenerative spine disease
Background:
- The Dynesys system is a semirigid dorsal pedicular stabilization device used since 1994.
- Short-term outcomes of Dynesys instrumentation are reported, but long-term results for L4/5 degenerative spondylolisthesis are less understood.
Purpose of the Study:
- To evaluate the long-term clinical and radiographic outcomes of patients with monosegmental L4/5 degenerative spondylolisthesis treated with the Dynesys device.
Main Methods:
- Retrospective analysis of prospectively collected data from 39 patients with L4/5 degenerative spondylolisthesis.
- Patients underwent bilateral decompression and Dynesys instrumentation.
- Mean follow-up was 7.2 years, including clinical, radiographic, and quality of life assessments.
Main Results:
- Significant improvement in back pain (89%) and leg pain (86%) was observed.
- 83% reported global subjective improvement, and 92% would undergo the procedure again.
- 21% required revision surgery; 9 cases showed radiologic progression of spondylolisthesis; adjacent segment pathology was noted in 17.9% (L5/S1) and 28.2% (L3/4).
Conclusions:
- Monosegmental Dynesys instrumentation for L4/5 degenerative spondylolisthesis yields favorable long-term results.
- The rate of secondary surgeries is comparable to other dorsal stabilization devices.
- Dynesys offers a viable alternative, demonstrating high patient satisfaction and a low incidence of adjacent segment degeneration.
