Dynamic compared to rigid fixation in lumbar spine: a systematic review

Abstract

Objective: The objective of this review is to reveal the quality of published data and the effect size of DPFs compared to rigid fixation in lumbar spine. Summary of background data: since 2002, several dynamic pedicle fixation (DPF) systems have been developed with the aim to stabilize the spine without the undesirable effects of rigid lumbar spine fixation. Nearly ten years later, there are several studies on these dynamic systems. Methods: A systematic review was done in MEDLINE/PubMED, Embase, Cochrane Central Register of Randomized Trials and Google Scholar to assess the quality of published literature and the available studied outcomes in randomized controlled trials of DPF. Results: Only three papers described randomized trials studying DPF. One of them focused on protection of adjacent level disease provided by DPF. Conclusion: It was not possible to reveal any evidence for benefits using DPF compared to rigid fixation in surgery for lumbar spine.

Dynamic stabilization of the spine in osteoporotic patients

“…Although dynamic spinal fusion systems are designed to protect the spine from adverse effects of rigid fixation, ten years of clinical use have failed to demonstrate the superiority of these systems in clinical or radiographic results. There were no differences in the rate of degeneration in adjacent dynamic systems compared to rigid systems 12,13 .…”

Only fixation for lumbar canal stenosis

“…Of interest, Botelho et al noted that “it was not possible to reveal any evidence for benefits using DPF compared to rigid fixation in surgery for lumbar spine. [3]” Focusing on the use of “double insurance” transarticular method, it seems that Goel successfully used it in his experience. [124] However, the result of spine surgery depends on several factors including to setting, experience of the surgeon as well as the race of the patients.…”