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Spinal motion preservation surgery: indications and applications.

Ioannis D Gelalis1, Dimitrios V Papadopoulos2,3, Dionysios K Giannoulis1

  • 1Department of Οrthopedics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|October 8, 2017
PubMed
Summary

Spinal fusion can cause adjacent level disease. Motion-preserving surgeries like disc replacement and dynamic stabilization offer alternatives but have specific indications and limitations for optimal patient outcomes.

Keywords:
Dynamic posterior stabilizationInterspinous implantsLaminoplastyTotal disc replacement

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Area of Science:

  • Spinal surgery
  • Orthopedics
  • Neurosurgery

Background:

  • Spinal fusion is a common procedure for various spinal issues.
  • Fusion leads to accelerated degeneration at adjacent spinal levels, termed adjacent level disease.
  • Motion preservation surgical techniques aim to mitigate this complication.

Purpose of the Study:

  • To review motion preservation surgical methods as alternatives to spinal fusion.
  • To discuss the clinical usefulness and limitations of current motion preservation techniques.

Main Methods:

  • Review of literature on motion preservation spinal surgeries.
  • Analysis of indications, contraindications, and outcomes for different techniques.

Main Results:

  • Total disc replacement is indicated for degenerative disc disease but has many contraindications.
  • Interspinous implants show promise for spinal stenosis, but precise indications require further definition.
  • Laminoplasty offers advantages over fusion/laminectomy for cervical myelopathy/radiculopathy.
  • Dynamic posterior stabilization may replace fusion in select cases, primarily for mild to moderate conditions.

Conclusions:

  • Motion preservation techniques present viable alternatives to spinal fusion.
  • Each technique has specific indications and limitations that must be carefully considered.
  • Further research is needed to refine the application and indications for these emerging surgical options.