Following lumbar fusion, adjacent segment degeneration has been frequently reported. Dynamic systems are believed to reduce main fusion drawbacks. We conducted a retrospective study on patients with degenerative lumbar disease treated with posterior dynamic stabilization with monoaxial hinged pedicular screws and lumbar decompression. VAS and ODI were used to compare clinical outcomes. As radiological outcomes, LL and SVA were used. 51 patients were included with an average follow-up of 24 months. 13 patients were revised because of postoperative radiculopathy (n=4), subcutaneous hematoma (n=2), L5 screw malposition (n=1) and adjacent segment disease (n=6). The mean ODI score 41 preoperatively compared to 36 postoperatively. The mean VAS scores for back and leg pain were 5.3 and 4.2, respectively compared to 4.5 and 4.0 postoperatively. The mean SVA was 5.3 cm preoperatively, and 5.7 cm postoperatively. The mean LL was 47.5° preoperatively and 45.5° postoperatively. From our data, which fail to show significant improvements and reflect a high revision rate, we cannot generally recommend dynamic stabilization as an alternative to fusion. Comparative trials with longer follow-ups are required.
Keywords: Dynamic stabilization; degenerative lumbar spine; degenerative scoliosis; degenerative spondylolisthesis.