Complications of 2-Level Dynamic Stabilization: A Correlative Clinical and Radiological Analysis at Two-Year...

Area of Science:

• Spine surgery
• Orthopedic biomechanics
• Degenerative spinal disorders

Background:

• Dynamic stabilization systems offer an alternative to rigid fixation in lumbar spine surgery.
• Understanding complications associated with multi-level dynamic stabilization is crucial for patient outcomes.

Purpose of the Study:

• To evaluate postoperative complications, specifically screw loosening, screw breakage, and adjacent segment disease (ASD).
• To assess clinical improvements and radiological parameters following 2-level dynamic stabilization.

Main Methods:

• Retrospective review of 103 patients with lumbar degenerative spinal instability who underwent 2-level dynamic stabilization.
• Clinical findings, screw integrity (loosening/breakage), and ASD were assessed at 2-year follow-up.
• Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were used for clinical evaluation.

Main Results:

• Significant improvements in VAS and ODI scores were observed at 4 months, 1 year, and 2 years postoperatively.
• Adjacent segment disease (ASD) occurred in 12 patients (11.7%).
• Nine cases of screw breakage and 4 cases of screw loosening were reported, indicating a high complication rate.

Conclusions:

• Two-level dynamic stabilization is associated with a notable incidence of complications, including screw failure and ASD.
• The increased rigidity of multi-level instrumented systems may contribute to higher complication rates compared to single-level applications.
• Further research is warranted to optimize dynamic stabilization techniques for multi-level spinal fusions.