Short-term clinical observation of the Dynesys neutralization system for the treatment of degenerative disease of the lumbar vertebrae.

Abstract

To explore the safety and short-term efficacy of the posterior approach of the Dynesys dynamic neutralization system for degenerative disease of the lumbar vertebrae. From March 2008 to March 2010, 32 cases of degenerative lumbar vertebral disease, 19 men and 13 women, (mean age 58 ± 5.2, range, 43-78 years), were treated with posterior laminectomy and Dynesys internal fixation. All patients had a history of over 3 months waist or leg pain that had not been relieved by conservative treatment. There were 10 cases of single lumbar intervertebral disc protrusion, 14 of degenerative lumbar spinal stenosis, 5 of degenerative lumbar isthmic spondylolisthesis, and 3 of recurrent lumbar disc protrusion after surgery. A visual analogue score (VAS) was used for pain assessment, and the Oswestry disability index (ODI) for functional evaluation of clinical outcomes. All patients were followed up for 6-23 months (mean, 16.4 ± 5.5 months). Forty-one segments in 32 patients were stabilized; 23 cases (71.9%) underwent single-segmental stabilization, and 9 (28.1%) two-segmental stabilization. VAS of leg pain, root and low back pain was significantly improved postoperatively. The ODI improved from preoperative 69% ± 12.6% to postoperative 28% ± 15.7% (P < 0.001). On the stabilized segment and adjacent segments above and below, the range of movement showed no statistical difference; no loosening of screws, cord and polyester spacer occurred. The Dynesys dynamic neutralization system combined with decompression can achieve satisfactory short-term clinical results in lumbar degenerative disease. This procedure system not only reduces back and leg pain, but also preserves the mobility of fixed segments, minimizes tissue injury and avoids taking bone for spinal fusion. © 2011 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.