COMPARATIVE STUDY OF DYNAMIC NEUTRALIZATION SYSTEM AND POSTERIOR LUMBAR INTERBODY FUSION IN TREATING LUMBAR DEGENERATIVE DISEASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Bing , JIANG Tingbiao.

No.1 Department of Orthopedic Surgery, Hospital of Orthopedics of Yulin, Yulin Guangxi, 537000, P.R.China. Corresponding author: YANG Bing, E-mail: yb2386696@163.com;

Corresponding author：

Keywords：

Lumbar degenerative disease; Dynamic neutralization system; Posterior lumbar interbody fusion

DOI：

10.7507/1002-1892.20130032

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Objective To compare the short-term effectiveness between dynamic neutralization system (Dynesys) and posterior lumbar interbody fusion (PLIF) in the treatment of lumbar degenerative disease. Methods The clinical data were retrospectively analyzed, from 14 patients undergoing Dynesys and 18 patients undergoing PLIF to treat lumbar degenerative disease between February 2009 and March 2011. No significant difference in gender, age, duration of disease, and lesion segments was found between 2 groups (P gt; 0.05). The visual analogue scale (VAS) score, Oswestry disability index (ODI), and radiographic results were compared between 2 groups at preoperation and last follow-up. Results Thirty-one cases were followed up 12-21 months (mean, 17 months). No internal fixation loosening, broken screws, and broken rods was found during follow-up. The mean interbody fusion time was 15 months (range, 13-19 months) in PLIF group. The VAS score and ODI were significantly improved in 2 groups at last follow-up when compared with the preoperative ones (P lt; 0.05); but there was no signficant difference between 2 groups (P gt; 0.05). Imaging assessment: the range of motion (ROM) of operated segment in PLIF group was (0.1 ± 0.4)° at last follow-up, showing significant difference when compared with preoperative ROM (7.8 ± 0.6)° (t=28.500, P=0.004); the ROM in Dynesys group (5.0 ± 1.5)° decreased, but showing no significant difference when compared with preoperative ROM (7.5 ± 0.8)° (t=0.480, P=0.113); and significant difference was found between 2 groups (t=5.260, P=0.008) at last follow-up. The ROM of adjacent segment in Dynesys group at last follow-up (7.2 ± 0.7)° decreased when compared with preoperative ROM (7.3 ± 1.8)°, but showing no significant difference (t=0.510, P=0.108); however, ROM of adjacent segment in PLIF group (8.7 ± 0.4)° increased significantly when compared with preoperative ROM (7.0 ± 1.6)°, showing signifcant difference (t=3.440, P=0.042); and there was significant difference between 2 groups (t= — 2.100, P=0.047) at last follow-up. Conclusion Dynesys and PLIF have equivalent short-term effectivness in the treatment of lumbar degenerative disease. However, the Dynesys could retain ROM of operated segment without increased ROM of the adjacent segment, which will promote the disc recovery of operated segment and prevent degeneration of adjacent segment.

Citation： YANG Bing,JIANG Tingbiao.. COMPARATIVE STUDY OF DYNAMIC NEUTRALIZATION SYSTEM AND POSTERIOR LUMBAR INTERBODY FUSION IN TREATING LUMBAR DEGENERATIVE DISEASE. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(2): 140-144. doi: 10.7507/1002-1892.20130032 Copy

1.	Stoll TM, Dubois G, Schmarzenhach O. The dynamic neutralization system for the spine: a multi-center study of a novel non-fusion system. Eur Spine J, 2002, 11 Suppl 2: S170-178.
2.	Schmoelz W, Huber JF, Nydegger T, et al. Influence of a dynamic stabilization system on load bearing of a bridged disc: an in vitro study of intradiscal pressure. Eur Spine J, 2006, 15(8): 1276-1285.
3.	Schmoelz W, Huber JF, Nydegger T, et al. Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment. J Spinal Disord Tech, 2003, 16(4): 418-423.
4.	Grob D, Benini A, Junge A, et al. Clinical expenience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient- onentel outcome in 50 cases after an average of 2 years. Spine (Phila Pa 1976), 2005, 30(3): 324-331.
5.	Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976), 2000, 25(22): 2940-2952.
6.	Gibson JN, Grant IC, Waddell G. The cochrane review of srugery for lumbar disc prolapse and degenerative lumbar spondylosis. Spine (Phila Pa 1976), 1999, 24(17): 1820-1832.
7.	Kumar MN, Baklanov A, Chopin D. Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J, 2001, 10(4): 314-319.
8.	梁春红, 丁亮华, 吴采荣, 等. Dynesys动态稳定系统与腰椎退变性疾病. 国际骨科学杂志, 2009, 30(5): 320-322.
9.	Dubois G. Dynamic stabilization with the Dynesys system and the dynamic transition option DTO implant: philosophy-concept surgical technique. Interact Surg, 2008, 3(4): 239-244.
10.	Cakir B, Carazzo C, Schmidt R, et al. Adjacent segment mobility after rigid seminigid instramentation of lumbar spine. Spine (Phila Pa 1976), 2009, 34(12): 1278-1291.
11.	Vaga S, Brayda-Bruno M, Perona F, et al. Molecular MR imaging for the evaluation of the effect of dynamic stabilization on lumbar intervertebral discs. Eue Spine J, 2009, 18 Suppl 1: 40-48.
12.	Würgler-Hauri CC, Kalbarczyk A, Wiesli M, et al. Dynamic neutralization of the lumbar spine after microsurgical decompression in acquired lumbar spinal stenosis and segmental instability. Spine (Phila Pa 1976), 2008, 33(3): E66-72.
13.	Bordes-Monmeneu M, Bordes-Garcia V, Rodrigo-Baeza F, et al. System of dynamic neutralization in the lumbar spine: experience on 94 cases. Neurocirugia (Astur), 2005, 16(6): 499-506.
14.	Putzier M, Schneider SV, Funk J, et al. Application of a dynamicpedicle screw system (DYNESYS) for lumbar segmental degenerations-comparison of clinical and radiological results for different indications. Z Orthop Ihre Grenzgeb, 2004, 142(2): 166-173.
15.	Schmoelz W, Huber JF, Nydegger T, et al. Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment. J Spinal Disord Tech, 2003, 16(4): 418-423.
16.	殷渠东, Jeanneret B. Dynesys 治疗腰椎退变和不稳(附13例报告). 中国矫形外科杂志, 2007, 7(15): 491-493.
17.	Ko CC, Tsai HW, Huang WC, et al. Screw loosening in the Dynesys stabilization system: radiographic evidence and effect on outcomes. Neurosurg Focus, 2010, 28(6): E10.

1. Stoll TM, Dubois G, Schmarzenhach O. The dynamic neutralization system for the spine: a multi-center study of a novel non-fusion system. Eur Spine J, 2002, 11 Suppl 2: S170-178.
2. Schmoelz W, Huber JF, Nydegger T, et al. Influence of a dynamic stabilization system on load bearing of a bridged disc: an in vitro study of intradiscal pressure. Eur Spine J, 2006, 15(8): 1276-1285.
3. Schmoelz W, Huber JF, Nydegger T, et al. Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment. J Spinal Disord Tech, 2003, 16(4): 418-423.
4. Grob D, Benini A, Junge A, et al. Clinical expenience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient- onentel outcome in 50 cases after an average of 2 years. Spine (Phila Pa 1976), 2005, 30(3): 324-331.
5. Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976), 2000, 25(22): 2940-2952.
6. Gibson JN, Grant IC, Waddell G. The cochrane review of srugery for lumbar disc prolapse and degenerative lumbar spondylosis. Spine (Phila Pa 1976), 1999, 24(17): 1820-1832.
7. Kumar MN, Baklanov A, Chopin D. Correlation between sagittal plane changes and adjacent segment degeneration following lumbar spine fusion. Eur Spine J, 2001, 10(4): 314-319.
8. 梁春红, 丁亮华, 吴采荣, 等. Dynesys动态稳定系统与腰椎退变性疾病. 国际骨科学杂志, 2009, 30(5): 320-322.
9. Dubois G. Dynamic stabilization with the Dynesys system and the dynamic transition option DTO implant: philosophy-concept surgical technique. Interact Surg, 2008, 3(4): 239-244.
10. Cakir B, Carazzo C, Schmidt R, et al. Adjacent segment mobility after rigid seminigid instramentation of lumbar spine. Spine (Phila Pa 1976), 2009, 34(12): 1278-1291.
11. Vaga S, Brayda-Bruno M, Perona F, et al. Molecular MR imaging for the evaluation of the effect of dynamic stabilization on lumbar intervertebral discs. Eue Spine J, 2009, 18 Suppl 1: 40-48.
12. Würgler-Hauri CC, Kalbarczyk A, Wiesli M, et al. Dynamic neutralization of the lumbar spine after microsurgical decompression in acquired lumbar spinal stenosis and segmental instability. Spine (Phila Pa 1976), 2008, 33(3): E66-72.
13. Bordes-Monmeneu M, Bordes-Garcia V, Rodrigo-Baeza F, et al. System of dynamic neutralization in the lumbar spine: experience on 94 cases. Neurocirugia (Astur), 2005, 16(6): 499-506.
14. Putzier M, Schneider SV, Funk J, et al. Application of a dynamicpedicle screw system (DYNESYS) for lumbar segmental degenerations-comparison of clinical and radiological results for different indications. Z Orthop Ihre Grenzgeb, 2004, 142(2): 166-173.
15. Schmoelz W, Huber JF, Nydegger T, et al. Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment. J Spinal Disord Tech, 2003, 16(4): 418-423.
16. 殷渠东, Jeanneret B. Dynesys 治疗腰椎退变和不稳(附13例报告). 中国矫形外科杂志, 2007, 7(15): 491-493.
17. Ko CC, Tsai HW, Huang WC, et al. Screw loosening in the Dynesys stabilization system: radiographic evidence and effect on outcomes. Neurosurg Focus, 2010, 28(6): E10.

Chinese Journal of Reparative and Reconstructive Surgery

COMPARATIVE STUDY OF DYNAMIC NEUTRALIZATION SYSTEM AND POSTERIOR LUMBAR INTERBODY FUSION IN TREATING LUMBAR DEGENERATIVE DISEASE

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