Neurospine.
2018 Sep;15(3):231-241. 10.14245/ns.1836108.054.
A Hybrid Dynamic Stabilization and Fusion System in Multilevel Lumbar Spondylosis
- Affiliations
-
- 1Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. jauching@gmail.com, wchuang@vghtpe.gov.tw
- 2School of Medicine, National Yang-Ming University, Taipei, Taiwan.
- 3Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
- 4Taiwan International Graduate Program in Molecular Medicine, National Yang-Ming University and Academia Sinica, Taipei, Taiwan.
- 5Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
- 6Ophthalmology Department, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
- 7Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
- KMID: 2426309
- DOI: http://doi.org/10.14245/ns.1836108.054
Abstract
- BACKGROUND/AIMS
The Dynesys-Transition-Optima (DTO) hybrid system was designed to achieve arthrodesis and stabilization in patients with lumbar degeneration. Satisfactory outcomes were demonstrated previously. However, no study has evaluated the effects of using the DTO system in patients with lumbar spondylolisthesis or stenosis.
METHODS
This retrospective study included 35 consecutive patients with multilevel lumbar degeneration with or without spondylolisthesis who underwent surgery using the DTO system. Imaging studies included pre- and postoperative radiography, magnetic resonance imaging, and computed tomography. The clinical outcomes were measured by Japanese Orthopedic Association (JOA) scores, Oswestry Disability Index (ODI) scores, and a visual analogue scale (VAS) for back and leg pain.
RESULTS
Thirty patients (85.7%) with a mean age of 61.9 years completed the follow-up, with a mean duration of 35.1 months. There were 21 patients in the spondylolisthesis group and 9 in the stenosis group. The spondylolisthesis group had worse functional scores than the stenosis group preoperatively. After DTO surgery, all patients showed significant improvements in clinical outcomes, including VAS for back and leg pain, ODI, and JOA scores (p < 0.05). There were no significant differences in clinical outcomes between the 2 groups. At a 2-year follow-up, lumbar alignment was well maintained in both groups (p = 0.116). There were no significant differences in lumbar alignment between the 2 groups.
CONCLUSION
During a follow-up period of over 2 years, both patients with spondylolisthesis and those with stenosis showed improvements and similar disability and pain scores after surgery using the DTO system. Lumbar alignment was also well maintained.
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