Skip to main content
SpringerLink
Log in

Dynamic posterior stabilization for degenerative lumbar spine disease: a large consecutive case series with long-term follow-up by additional postal survey

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

An Erratum to this article was published on 03 May 2016

Abstract

Introduction

Dynamic stabilization of the degenerated spine was invented to overcome the negative side effects of fusion surgery like adjacent segment degeneration. Amongst various different implants DSS® is a pedicle-based dynamic device for stabilizing the spine and preserving motion. Nearly no clinical data of the implant have been reported so far. The current analysis presents results from a single spine surgeon who has been using DSS® for the past 5 years and recorded all treatment and outcome data in the international Spine Tango registry.

Materials/methods

From the prospectively documented overall patient pool 436 cases treated with DSS® could be identified. The analysis was enhanced with a mailing of COMI patient questionnaires for generating longer-term follow-ups up to 4 years.

Results

387 patients (189 male, 198 female; mean age 67.3 years) with degenerative lumbar spinal disease including degenerative spondylolisthesis (6.1 %) could be evaluated. The type of degeneration was mainly spinal stenosis (89.9 %). After a mean follow-up of 1.94 years, the COMI score and NRS back and leg pain improved significantly and to a clinically relevant extent. The postoperative trend analysis could not determine a relevant deterioration of these outcomes until 4 years postoperative. 10 patients were revised (2.6 %) and the implant was removed; in most cases, a fusion was performed. Another 5 cases (1.3 %) had an extension of the dynamic stabilization system to the adjacent level. 84.2 % of patients rated that the surgery had helped a lot or had helped.

Discussion

The results of this large consecutive series with a follow-up up to 4 years could demonstrate a good and stable clinical outcome after posterior dynamic stabilization with DSS®. For degenerative diseases of the lumbar spine, this treatment seems to be a valid alternative to fusion surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Greiner-Perth R, Boehm H, Allam Y, Elsaghir H, Franke J (2004) Reoperation rate after instrumented posterior lumbar interbody fusion: a report on 1680 cases. Spine 29:2516–2520

    Article  PubMed  Google Scholar 

  2. Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE (2004) Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine 29:1938–1944

    Article  PubMed  Google Scholar 

  3. Chamoli U, Diwan AD, Tsafnat N (2013) Pedicle screw-based posterior dynamic stabilizers for degenerative spine: in vitro biomechanical testing and clinical outcomes. J Biomed Mater Res Part A. doi:10.1002/jbma.34986

    Google Scholar 

  4. Charles YP, Walter A, Schuller S, Steib JP (2011) Dynamic instrumentation of the lumbar spine. Clinical and biomechanical analysis of success factors. Orthopade 40:703–712. doi:10.1007/s00132-011-1800-z

    Article  CAS  PubMed  Google Scholar 

  5. Wilke HJ, Heuer F, Schmidt H (2009) Prospective design delineation and subsequent in vitro evaluation of a new posterior dynamic stabilization system. Spine 34:255–261. doi:10.1097/BRS.0b013e3181920e9c

    Article  PubMed  Google Scholar 

  6. Kafer W, Cakir B, Midderhoff S, Reichel H, Wilke HJ (2014) Circumferential dynamic stabilization of the lumbar spine: a biomechanical analysis. Eur Spine J 23:2330–2339. doi:10.1007/s00586-014-3286-y

    Article  PubMed  Google Scholar 

  7. Mannion AF, Elfering A, Staerkle R, Junge A, Grob D, Semmer NK, Jacobshagen N, Dvorak J, Boos N (2005) Outcome assessment in low back pain: How low can you go? Eur Spine J 14:1014–1026. doi:10.1007/s00586-005-0911-9

    Article  PubMed  Google Scholar 

  8. Ostelo RW, Deyo RA, Stratford P, Waddell G, Croft P, Von Korff M, Bouter LM, de Vet HC (2008) Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine 33:90–94. doi:10.1097/BRS.0b013e31815e3a10

    Article  PubMed  Google Scholar 

  9. Hagg O, Fritzel P, Nordwall A, Swedish Lumbar Spine Study G (2003) The clinical importance of changes in outcome scores after treatment for chronic low back pain. Eur Spine J 12:12–20. doi:10.1007/s00586-002-0464-0

    CAS  PubMed  Google Scholar 

  10. Bertagnoli R (2011) Functional pedicle based posterior dynamic stabilization system (DSS)–First results. In: ISASS 2011, Las Vegas, p 166. http://www.isass.org/pdf/SAS11_Abstract_Book.pdf

  11. Lorio MP, Lewis BM, C HR (2013) Post-Market Surveillance Pedicle Based dynamic Stabilization System (DSS). In: ISASS 2013, Vancouver, p 195. http://www.isass.org/pdf/ISASS13_Abstract_Book.pdf

  12. Schaeren S, Broger I, Jeanneret B (2008) Minimum four-year follow-up of spinal stenosis with degenerative spondylolisthesis treated with decompression and dynamic stabilization. Spine 33:E636–642. doi:10.1097/BRS.0b013e31817d2435

    Article  PubMed  Google Scholar 

  13. Hoppe S, Schwarzenbach O, Aghayev E, Bonel H, Berlemann U (2012) Long-term outcome after monosegmental L4/5 stabilization for degenerative spondylolisthesis with the dynesys device. J Spinal Disord Tech. doi:10.1097/BSD.0b013e318277ca7a

    Google Scholar 

  14. Di Silvestre M, Lolli F, Bakaloudis G, Parisini P (2010) Dynamic stabilization for degenerative lumbar scoliosis in elderly patients. Spine 35:227–234. doi:10.1097/BRS.0b013e3181bd3be6

    Article  PubMed  Google Scholar 

  15. Sapkas G, Mavrogenis AF, Starantzis KA, Soultanis K, Kokkalis ZT, Papagelopoulos PJ (2012) Outcome of a dynamic neutralization system for the spine. Orthopedics 35:e1497–1502. doi:10.3928/01477447-20120919-19

    Article  PubMed  Google Scholar 

  16. Robinson Y, Michaelsson K, Sanden B (2013) Instrumentation in lumbar fusion improves back pain but not quality of life 2 years after surgery. A study of 1310 patients with degenerative disc disease from the Swedish Spine Register SWESPINE. Acta Orthop 84:7–11. doi:10.3109/17453674.2013.771300

    Article  PubMed  PubMed Central  Google Scholar 

  17. Liu X, Wang Y, Qiu G, Weng X, Yu B (2014) A systematic review with meta-analysis of posterior interbody fusion versus posterolateral fusion in lumbar spondylolisthesis. Eur Spine J 23:43–56. doi:10.1007/s00586-013-2880-8

    Article  PubMed  Google Scholar 

  18. Abdu WA, Lurie JD, Spratt KF, Tosteson AN, Zhao W, Tosteson TD, Herkowitz H, Longely M, Boden SD, Emery S, Weinstein JN (2009) Degenerative spondylolisthesis: does fusion method influence outcome? Four-year results of the spine patient outcomes research trial. Spine 34:2351–2360. doi:10.1097/BRS.0b013e3181b8a829

    Article  PubMed  PubMed Central  Google Scholar 

  19. Mannion AF, Porchet F, Kleinstuck FS, Lattig F, Jeszenszky D, Bartanusz V, Dvorak J, Grob D (2009) The quality of spine surgery from the patient’s perspective. Part 1: the core outcome measures index in clinical practice. Eur Spine J 18(Suppl 3):367–373. doi:10.1007/s00586-009-0942-8

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopädische und Neurochirurgische Gemeinschaftspraxis, Eppenreuther Straße 28, 95032, Hof, Germany

    R. Greiner-Perth

  2. Regionalspital Emmental AG, Hospital Burgdorf, Oberburgstrasse 54, 3400, Burgdorf, Switzerland

    N. Sellhast

  3. Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland

    G. Perler, D. Dietrich, L. P. Staub & C. Röder

  4. Institute for Mathematical Statistics and Actuarial Science, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland

    D. Dietrich

Authors
  1. R. Greiner-Perth
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Sellhast
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Perler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. Dietrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. P. Staub
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C. Röder
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. P. Staub.

Ethics declarations

Conflict of interest

The postal survey and the data entry of returned COMI questionnaires were financially supported by Paradigm Spine GmbH, Wurmlingen, Germany. No further funding has been received for the conduct of this study and/or preparation of this manuscript.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00586-016-4600-7.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Greiner-Perth, R., Sellhast, N., Perler, G. et al. Dynamic posterior stabilization for degenerative lumbar spine disease: a large consecutive case series with long-term follow-up by additional postal survey. Eur Spine J 25, 2563–2570 (2016). https://doi.org/10.1007/s00586-016-4532-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-016-4532-2

Keywords

Search

Navigation