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The value of fixed segment mobility in posterior dynamic stabilization: a single-center retrospective study
Yulu Sun1, Jianbin Guan2, Hao Chen2
1Yangling Demonstration Zone Hospital, Yangling, 712100, China.
BMC Musculoskeletal Disorders
|February 1, 2025
Summary
The Isobar EVO dynamic stabilization system better preserves the surgical segment and slows degeneration in adjacent segments compared to the Isobar TTL system. This highlights the benefits of increased mobility in posterior dynamic stabilization devices.
Area of Science:
- Spine surgery
- Orthopedic biomechanics
- Medical device technology
Background:
- Posterior dynamic stabilization is used in spinal surgery to manage degenerative conditions.
- Two generations of the Isobar system, Isobar TTL (less mobile) and Isobar EVO (more mobile), exist.
- Understanding the long-term effects of these systems on spinal segments is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare the effects of Isobar TTL and Isobar EVO dynamic fixation systems on surgical and adjacent intervertebral disc segments using MRI.
- To evaluate clinical and radiographic outcomes between the two Isobar generations.
Main Methods:
- Retrospective analysis of 29 patients treated with Isobar EVO and 34 with Isobar TTL after fenestrated decompression.
- Radiographic parameters assessed included disc height index (DHI), range of motion (ROM), lateral neural foraminal protrusion value (LNPV), and Pfirrmann disc degeneration grading.
- Clinical outcomes (VAS, ODI) were also compared between groups.
Main Results:
- No significant differences in VAS or ODI scores were found between the Isobar EVO and Isobar TTL groups at 48 months.
- The Isobar EVO group showed significantly higher surgical segment DHI and ROM compared to the Isobar TTL group.
- The Isobar EVO group exhibited significantly lower upper adjacent segment ROM but a larger LNPV compared to the Isobar TTL group.
- Surgical segments treated with Isobar TTL showed greater disc degeneration (Pfirrmann grading) than those treated with Isobar EVO.
Conclusions:
- The second-generation Isobar EVO system provides superior preservation of the surgical spinal segment compared to the first-generation Isobar TTL.
- Isobar EVO demonstrates a beneficial effect in slowing the progression of degeneration in adjacent spinal segments.
- Increased mobility in posterior dynamic stabilization devices, as exemplified by Isobar EVO, offers advantages for spinal health.
