Dynamic stabilization adjacent to single-level fusion: part II. No clinical benefit for asymptomatic, initially degenerated adjacent segments after 6 years follow-up.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Michael PutzierPatrick Strube

Abstract

Progression of degeneration is often described in patients with initially degenerated segment adjacent to fusion (iASD) at the time of surgery. The aim of the present study was to compare dynamic fixation of a clinically asymptomatic iASD, with circumferential lumbar fusion alone. 60 patients with symptomatic degeneration of L5/S1 or L4/L5 (Modic ≥ 2°) and asymptomatic iASD (Modic = 1°, confirmed by discography) were divided into two groups. 30 patients were treated with circumferential single-level fusion (SLF). In dynamic fixation transition (DFT) patients, additional posterior dynamic fixation of iASD was performed. Preoperatively, at 12 months, and at a mean follow-up of 76.4 (60-91) months, radiological (MRI, X-ray) and clinical (ODI, VAS, satisfaction) evaluations assessed fusion, progression of adjacent segment degeneration (PASD), radiologically adverse events, functional outcome, and pain. At final follow-up, two non-fusions were observed in both groups. 6 SLF patients and 1 DFT patient presented a PASD. In two DFT patients, a PASD occurred in the segment superior to the dynamic fixation, and in one DFT patient, a fusion of the dynamically fixated segment was observed. 4 DFT patients presented radiological implant fail...Continue Reading

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Citations

Jan 21, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Robert C Mulholland
May 23, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jon A LutzGianluca Maestretti
Feb 14, 2013·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Masayuki MiyagiKazuhisa Takahashi
Jan 18, 2013·Advances in Orthopedics·Neel Anand, Eli M Baron
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Apr 15, 2014·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Chunpeng RenYoudi Xue
Sep 6, 2014·BMC Musculoskeletal Disorders·Jan SieweMarc Röllinghoff
Dec 26, 2012·The Spine Journal : Official Journal of the North American Spine Society·Tae-Ahn JahngKyung Yun Moon
Sep 29, 2011·The Orthopedic Clinics of North America·Teija Lund, Thomas R Oxland
Nov 15, 2011·Spine·Charles G FisherPeter G Whang
Oct 16, 2015·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Andrea BaioniAntonio Scarale
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Dec 5, 2013·World Journal of Clinical Cases·Alessandro Landi
Aug 11, 2018·Journal of Orthopaedic Surgery and Research·Stavros OikonomidisRolf Sobottke
Mar 13, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Aixing PanHui Guo
Dec 8, 2017·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Aldemar Andres HegewaldWerner Schmoelz
Apr 25, 2017·Clinical Spine Surgery : a Spine Publication·Michael ReichlAlexander Richter

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