Posterior Pedicle Fixation-based Dynamic Stabilization Devices for the Treatment of Degenerative Diseases of the Lumbar Spine: Institutional Study

Dr Maneet Gill; Dr Chinmaya Srivastava; Dr Lokesh Gautam; Dr Sudhanshu Agarwal

Volume : IX, Issue : VIII, August - 2020

Posterior Pedicle Fixation-based Dynamic Stabilization Devices for the Treatment of Degenerative Diseases of the Lumbar Spine: Institutional Study

Dr Maneet Gill, Dr Chinmaya Srivastava, Dr Lokesh Gautam, Dr Sudhanshu Agarwal

Abstract :

Background Fusion and rigid instrumentation is currently the mainstay for the surgical treatment of degenerative diseases of the spine over the last four decades. Rigid spinal implants along with fusion lead to increase in the stress of the adjacent segments and fatigue failure of implants. Although the spinal fusion had been the cornerstone of surgical treatment for back pain during the last three decades 1 in many cases persistent back pain despite a solid fusion continues to haunt the surgeons and patients2. Our institute did the retrospective study with series comparison of both types of stabilisation. This article compares the dynamic stabilization of the lumbar spine with rigid fusion in a series of ten cases at our institute and talks about chronologically some novel dynamics Methods: Study design: Retrospective study of comp� dynamic screw fixation with the rigid fixation Dates searched : Sep 2017- Sep 2018 at Army Hospital (R & R) Inclusion criteria: Painful degenerative lumbar disc disease with failed conservative management. Patients with grade one mobile spondylolisthesis. Single level dynamic stabilization. Patients with Chronic Low back ache with sciatica and claudication. Exclusion criteria: Patients less than 18 years and more than 70 years of age. Previous lumbar surgeries.Multi segment involvement. Verteal fracture or degenerative scoliosis. Patients with trauma, primary infection or inflammatory cause, fracture, Paget disease, osteochondrosis, congenital malformation, or visceral diseases, or previous lumbar surgery were excluded from the surgery Outcomes: Clinical outcomes (Visual analogue scale (VAS) for low back and lower leg pain; Oswestry disability index (ODI);) and radiological outcomes Results: Significant post op VAS improvement in both groups. Significant improvement of ODI in the dynamic group. Radiologically the involved discs in both the dynamic and rigid group continued to degenerate with loss of disc height (Rigid > Dynamic). Conclusions: Patients with posterior dynamic screw stabilisation has better relief of pain and maintenance of sagittal balance as compare to patients with standard rigid fixation. Dynamic screw stabilisation appears to be a good alternative to rigid fixation.