Complications associated with the Dynesys dynamic stabilization system: a comprehensive review of the literature

Abstract

<jats:p>The Dynesys dynamic stabilization system is an alternative to rigid instrumentation and fusion for the treatment of lumbar degenerative disease. Although many outcomes studies have shown good results, currently lacking is a comprehensive report on complications associated with this system, especially in terms of how it compares with reported complication rates of fusion. For the present study, the authors reviewed the literature to find all studies involving the Dynesys dynamic stabilization system that reported complications or adverse events. Twenty-one studies were included for a total of 1166 patients with a mean age of 55.5 years (range 39–71 years) and a mean follow-up period of 33.7 months (range 12.0–81.6 months). Analysis of these studies demonstrated a surgical-site infection rate of 4.3%, pedicle screw loosening rate of 11.7%, pedicle screw fracture rate of 1.6%, and adjacent-segment disease (ASD) rate of 7.0%. Of studies reporting revision surgeries, 11.3% of patients underwent a reoperation. Of patients who developed ASD, 40.6% underwent a reoperation for treatment. The Dynesys dynamic stabilization system appears to have a fairly similar complication-rate profile compared with published literature on lumbar fusion, and is associated with a slightly lower incidence of ASD.</jats:p>

Comparison between dynamic stabilization and instrumented fusion in the treatment of spinal stenosis with degenerative lumbar scoliosis

“…All 25 patients with screw loosening were asymptomatic, and in 6 (24%) osseous integration was demonstrated on later follow-up [29]. There were big differences in the incidence of screw loosening with the Dynesys system reported in the literature (range 0-73.5%), which might be related to the inconsistency of the diagnostic criteria [30]. In our study, the rate of screw loosening was lower compared with previous reports for several reasons.…”

Evaluation of a Hybrid Dynamic Stabilization and Fusion System in the Lumbar Spine: A 10 Year Experience

“…There is an abundance of literature regarding traditional, non-hybrid Dynesys instrumentation and its associated complications [ 26 - 27 ]. Infection rates have been generally well controlled during these procedures [ 12 , 27 ]. Our initial experience with DTO reported a wound infection rate of 8% [ 13 ].…”

“…This finding is also comparable to infection rates associated with instrumented arthrodesis, which varies from 1 to 11% [ 28 ]. Revision rates following DTO implantation are not well documented in the spine literature, but re-intervention after non-hybrid Dynesys instrumentation has been reported to be between 10 and 34% [ 10 - 12 , 27 ]. Grob, et al conducted a two-year follow-up in 31 patients that underwent Dynesys stabilization.…”

Clinical experiences of dynamic stabilizers: Dynesys and Dynesys top loading system for lumbar spine degenerative disease

“…In terms of the entire range of complications, a recent comprehensive review of the literature by Pham and colleagues [31] that included 21 studies and a total of 1166 patients indicated that the complication rate associated with the Dynesys system was fairly similar to that of lumbar fusion. Whether or not the DTL system also has a low complication rate requires further study.…”