Lumbar Dynamic Stabilization With 2-Stage Surgery: Early Results

Abstract

Background: Screw loosening, which is a major problem in dynamic systems, can be easily overcome with 2-stage surgery. In this article, the clinical and radiological results of patients undergoing dynamic stabilization with a Dynesys device in 2 stages are discussed.Methods: A total of 10 male and 13 female adult patients were included in this single-center retrospective study conducted between 2018 and 2021. The mean age of the patients was 65.6 years. All of the patients had pain complaints that affected their daily lives. Bone density T scores were determined with the dual-energy x-ray absorptiometry method before patients were admitted for surgery. In the first surgery, Dynesys system pedicle screws were inserted. After 6 months of osteointegration, Dynesys system spacers and elastic bandages were placed. Preoperative, early postoperative, and late postoperative visual analog pain scale (VAS) scores and Oswestry Disability Index (ODI) scores were determined and statistically compared.Results: Patients were followed for an average of 30 months. Complications and recurrence were not observed. Neurological deficits were not observed after patients recovered from anesthesia. Significant improvement was observed in the ODI and VAS parameters in the preoperative (ODI: 66.2%, VAS: 7.8), early postoperative (ODI: 20.3%, VAS: 2.4), and late postoperative (ODI: 6.8% and VAS: 1.1) periods. Symptomatic improvement was seen in all patients. No screw breakage or loosening was detected by radiological evaluation in any of the patients during the 2-year follow-up period.Conclusions: In our experience, the insufficiency of the proximal and distal end screws is eliminated when 2 stages of dynamic system stabilizations are completed after osteointegration of the screws.

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

“…We aimed to reduce PJK complication rates through dynamic stabilization using the Dynesys system. Furthermore, to reduce PJK rates related to osteoporosis, we preferred two-stage surgery where T was lower than −1.5, as previously described in our study [ 23 ]. In our cohort, the rate of PJK was 3%, which is much lower than that reported in the literature.…”

Clinical and radiological analysis of the effects of three different lumbar transpedicular dynamic stabilization system on disc degeneration and regeneration

“…In the first stage, we put the screws and wait for osteointegration to solidify, and we do the second stage after 4 months, perform decompression, and place the rods. In this way, in elderly patients with poor bone quality, we prevent screw from loosening ( 40 ).…”

Can Dynamic Spinal Stabilization Be an Alternative to Fusion Surgery in Adult Spinal Deformity Cases?

“…Dynamic stabilization and/or 2-stage spinal stabilization surgery have been reported as a solution to instrument failure and pseudoarthrosis, which are important complications of spinal fusion surgery. [22][23][24] In the present study, we share our experience of using dynamic system for the treatment of spinal SCI in adults.…”