Posterolateral fusion versus Dynesys dynamic stabilization: Retrospective study at a minimum 5.5years' follow-up

Area of Science:

• Spine surgery
• Orthopedics
• Neurosurgery

Background:

• Lumbar fusion is a common treatment for degenerative lumbar pathology.
• Dynamic stabilization techniques were developed to mitigate fusion complications like non-union and adjacent segment degeneration.
• Previous studies on dynamic stabilization have yielded controversial results.

Purpose of the Study:

• To compare the long-term radiological and clinical outcomes of lumbar fusion versus dynamic stabilization for degenerative lumbar conditions.

Main Methods:

• A retrospective, single-center study included 58 patients with recurrent lumbar disc herniation or stenosis.
• Patients underwent either posterolateral fusion or dynamic stabilization with neurologic release.
• Outcomes assessed included visual analog pain scale (VAS), Oswestry Disability Index (ODI), SF-12, adjacent segment disease (ASD), and intervertebral range of motion (ROM).

Main Results:

• The dynamic stabilization group (Dynesys®, 33 patients) showed significantly lower VAS scores and ODI compared to the fusion group (25 patients).
• The dynamic stabilization group had a significantly higher SF-12 physical subscore and greater intervertebral range of motion (ROM).
• Radiologic adjacent segment disease (ASD) was significantly higher in the fusion group (36%) than the dynamic stabilization group (12.1%).

Conclusions:

• Dynamic stabilization demonstrated comparable clinical and radiological results to posterolateral fusion for the studied indications.
• Dynamic stabilization may offer advantages in terms of pain reduction, functional improvement, and reduced adjacent segment disease.
• Further research may be needed, as the L5-S1 level was not included in this study.