A Retrospective Observational Study to Evaluate Adjacent Segmental Degenerative Change with the...

Area of Science:

• Spine surgery
• Orthopedic biomechanics
• Degenerative spine disease

Background:

• Adjacent segment disease (ASD) is a concern after lumbar spinal stenosis surgery.
• Hybrid dynamic stabilization aims to mitigate ASD.
• The Dynesys-Transition-Optima (DTO) system is one such approach.

Purpose of the Study:

• To evaluate the impact of the Dynesys-Transition-Optima (DTO) system on adjacent segment disease (ASD).
• To assess the effect of DTO on disc height, listhesis, and angular motion at adjacent segments in lumbar spinal stenosis patients with spondylolisthesis.

Main Methods:

• A cohort of 31 patients with lumbar spinal stenosis and spondylolisthesis treated with DTO stabilization was analyzed.
• Postoperative follow-up at 6, 12, and 24 months assessed key biomechanical parameters.
• Radiographic measurements included disc height, listhesis distance, and angular motion at L2-L3, L3-L4, and L5-S1.

Main Results:

• The L3-L4 segment (index level) showed delayed listhesis progression compared to other segments.
• At two years, the L3-L4 segment had less listhesis increase and disc height reduction than L2-L3 and L5-S1.
• A significant reduction in angular motion change was observed at the L3-L4 segment over two years.

Conclusions:

• Hybrid dynamic stabilization with the DTO system did not significantly prevent adjacent segment disease (ASD).
• However, the DTO system demonstrated minor and delayed degeneration at the index L3-L4 segment.
• Reduced angular motion at the index level suggests potential benefits of DTO for specific segment stabilization.