Dynamic Lumbar Pedicle Screw-Rod Stabilization: Two-Year Follow-Up and Comparison with Fusion
Ali Fahir Ozer*, 1, Neil R Crawford2, Mehdi Sasani1, Tunc Oktenoglu1, Hakan Bozkus1, Tuncay Kaner3, Sabri Aydin1
Identifiers and Pagination:Year: 2010
First Page: 137
Last Page: 141
Publisher Id: TOORTHJ-4-137
Article History:Received Date: 30/12/2009
Revision Received Date: 3/2/2010
Acceptance Date: 4/2/2010
Electronic publication date: 4/3/2010
Collection year: 2010
open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
A lumbar pedicular dynamic stabilization system (LPDSS) is an alternative to fusion for treatment of degenerative disc disease (DDD). In this study, clinical and radiological results of one LPDSS (Saphinaz, Medikon AS, Turkey) were compared with results of rigid fixation after two-year follow-up.
All patients had anteroposterior and lateral standing x-rays of the lumbar spine preoperatively and at 3 months, 12 months and 24 months after surgery. Lordosis of the lumbar spine, segmental lordosis and ratio of the height of the intervertebral disc spaces (IVS) measured preoperatively and at 3 months, 12 months and 24 months after surgery.
All patients underwent MRI and/or CT preoperatively, 3months, 12 months and 24 months postoperatively. The ratio of intervertebral disc space to vertebral body height (IVS) and segmental and lumbar lordosis were evaluated preoperatively and postoperatively. Pain scores were evaluated via Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) preoperatively and postoperatively.
In both groups, the VAS and ODI scores decreased significantly from preoperatively to postoperatively. There was no difference in the scores between groups except that a lower VAS and ODI scores were observed after 3 months in the LPDSS group. In both groups, the IVS ratio remained unchanged between preoperative and postoperative conditions. The lumbar and segmental lordotic angles decreased insignificantly to preoperative levels in the months following surgery.
Patients with LPDSS had equivalent relief of pain and maintenance of sagittal balance to patients with standard rigid screw-rod fixation. LPDSS appears to be a good alternative to rigid fixation.