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Title

Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis

Authors
Smoll, Nicolas
Oezkan, Neriman
Published in Acta Neurochirurgica. 2014, vol. 156, no. 2, p. 221-227
Abstract Abstract Background Different treatment options exist for symptomatic single-level degenerative anterolisthesis and stenosis. While simple micro-decompression has been advocated lately, most authors recommend posterior decompression with fusion. In recent years, decompression and dynamic transpedicular stabilisation has been introduced for this indication. The aim of this study was to evaluate the safety and efficacy of decompression and dynamic transpedicular stabilisation with the Dynesys® system in single-level degenerative anterolisthesis and stenosis. Methods Thirty consecutive patients with symptomatic single-level degenerative anterolisthesis and stenosis without scoliosis underwent decompression and single-level Dynesys stabilisation at the level of degenerative anterolisthesis. Patients were followed prospectively for 24 months with radiographs, Oswestry Disability Index scores, visual analogue scale (VAS) for back and leg pain, and estimated pain-free walking distance. Results At the 2-year follow-up, back pain was reduced from 6.5 preoperatively to 2.5, leg pain from 5.4 to 0.6. The painfree walking distance was estimated at 500 m preoperatively and at over 2 km after 2 years, while the ODI decreased from 54 % to 18 %. Screw loosening was found in 2/30 cases. Symptomatic adjacent segment disease was found in 3/30 patients between 12 and 24 months postoperatively. Conclusions Single-level Dynesys stabilisation combined with single- or multi-level decompression seems to be a safe and efficient treatment option in single-level degenerative anterolisthesis and stenosis over an observation period of 2 years, avoiding iliac crest or local bone grafting required by fusion procedures. However, it does not seem to avoid adjacent segment disease.
Keywords Lumbar stenosisDegenerative spondylolisthesis, Transpedicular stabilisationDynamic stabilisation
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Research group Groupe Schaller Karl Lothard (neurochirurgie) (851)
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PAYER, Michael et al. Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis. In: Acta Neurochirurgica, 2014, vol. 156, n° 2, p. 221-227. https://archive-ouverte.unige.ch/unige:90885

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Deposited on : 2017-01-06

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