Dynesys® dynamic stabilization outcomes in degenerative spine surgery

Abstract

Dynesys® is a dynamic device used for posterior stabilization of the lumbar spine. The objective of this study was to analyze the clinical and radiological outcomes at a 2-year minimum follow-up. In this retrospective study, patients operated between 2009 and 2016 with Dynesys® stabilization were in- cluded. 5 different etiologies were included: disc herniation, lumbar stenosis, revision for adjacent seg- ment disease (ASD), spondylolisthesis, and scoliosis. Clinical and radiological evaluations were performed. Postoperative complications and revisions were recorded. 136 patients were included: 34 for lumbar spinal stenosis, 19 for disc herniation, 29 degenerative spon- dylolisthesis, 41 revisions for ASD, and 13 scoliosis. Mean age was 64.8. Average clinical follow-up was 46 months. Postoperative clinical results showed a mean lumbar VAS of 3.07, a mean radicular VAS of 3.01 and an ODI score of 31.8%. The ASD rate was 16.2%, and overall revision rate was 11.8%. 2 cases (1.5%) of screw loosening were identified. Clinical outcomes, ASD rate and revision rate were more favorable in the spondylolisthesis and disc herniation groups. This study has one of the largest Dynesys® cohort in literature. Spinal dynamic stabilization by Dynesys® presents good long-term clinical and radiological out- comes with a lower rate of complications than pre- viously published cohorts and lumbar fusions. Best indications seem to be degenerative spondylolisthesis.

Use of Dynamic Spinal Instruments (Dynesys) in Adult Spinal Deformities According to Silva–Lenke and Berjano–Lamartina Classifications

“…In our cohort, the rate of PJK was 3%, which is much lower than that reported in the literature. Interestingly, the average blood loss (611.7 mL) in our study was much higher than that reported by Hsieh et al [24] (250 mL) and Yang et al [25] (386 mL) but similar to that reported by Khalife et al [26] (736 mL).…”

Evidence-based Indications for Vertebral Body Tethering in Spine Deformity

“…The Dynesys (Zimmer Biomet) was first developed for the treatment of degenerative spine conditions in adult patients 17 . This tether was used to provide dynamic stabilization in the treatment of spondylolisthesis, disk herniations, spinal stenosis, adjacent segment disease, and pseudarthrosis 17,18 . Junctional tethers have been used at the cranial aspect of long posterior instrumented constructs to distribute proximal motion segment stiffness and reduce proximal junctional kyphosis 19 .…”

“…17 This tether was used to provide dynamic stabilization in the treatment of spondylolisthesis, disk herniations, spinal stenosis, adjacent segment disease, and pseudarthrosis. 17,18 Junctional tethers have been used at the cranial aspect of long posterior instrumented constructs to distribute proximal motion segment stiffness and reduce proximal junctional kyphosis. 19 While this device has fallen out of favor for adult patients, 17 the device was implanted according to physician-directed use for VBT until it was removed from the US market in 2019.…”

Dynesys versus Dynamic Hybrid System in the treatment of Multi-Segmental Lumbar Degenerative Disease: a retrospective study

“…It could theoretically preserve the mobility of the operated segment and lessen the pressure on the adjacent discs and facet joints (9), which means that it can be installed in middle-aged patients with single-or multi-segmental LDD. Some studies have supported the purported bene cial effect of Dynesys in preserving range of motion (ROM) and preventing ASD in LDD patients (10)(11)(12)(13). Other studies refuted the claim and demonstrated that Dynesys failed to achieve that bene cial effect (14).…”