Skip to main content

Advertisement

SpringerLink
Log in

The Effect of Unintended Facet Arthrodesis on the Treatment Outcome of Dynamic Neutralization System for Lumbar Degenerative Diseases

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to examine the influence of unintended facet arthrodesis on the therapeutic effectiveness of the dynamic neutralization system (Dynesys).

Methods

This retrospective study enrolled consecutive patients who underwent posterior decompression and dynamic stabilization for lumbar spondylosis or spinal stenosis. Follow-up assessments included lumbar radiography, lumbar vertebral computerized tomography (CT), visual analog scale (VAS), and Oswestry disability index (ODI). Patients were classified into the facet fusion and non-fusion groups. The differences in the VAS scores for back pain and leg pain, ODI, intervertebral range of motion (ROM) at the surgical segments, and upper adjacent segments were assessed before and after treatment.

Results

A total of 49 patients (29 males and 20 females) aged 31–65 years were enrolled and followed-up for over 40 months. Among the patients, 16 (32.7%) experienced unintended facet arthrodesis and were assigned to the fusion group, whereas the remaining patients were assigned to the non-fusion group. There was a significant increase in the incidence of facet arthrodesis in the surgical segments over time post-surgery (χ2 = 6.2, p < 0.05). The ROM of the surgical and upper adjacent segments, VAS scores for back pain and leg pain, and ODI were all significantly different before and after the operation (p < 0.05), but not between the fusion and non-fusion groups (p > 0.05).

Conclusion

Although unintended facet arthrodesis is common after Dynesys procedure, the presence of facet arthrodesis does not significantly affect the efficacy of Dynesys in treating lumbar degenerative diseases.

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.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Availability of Data and Material

The datasets used during the current study are available from the corresponding author on reasonable request.

References

  1. Wang, T., & Ding, W. (2020). Risk factors for adjacent segment degeneration after posterior lumbar fusion surgery in treatment for degenerative lumbar disorders: a meta-analysis. Journal of Orthopaedic Surgery and Research, 15(1), 582. https://doi.org/10.1186/s13018-020-02032-7. Epub 2020/12/05.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kim, S. I., Min, H. K., Ha, K. Y., Park, H. Y., Cho, C. H., Cho, R. K., & Kim, Y. H. (2020). Effects of restoration of sagittal alignment on adjacent segment degeneration in instrumented lumbar fusions. Spine (Phila Pa 1976), 45(23), E1588–E1595. https://doi.org/10.1097/BRS.0000000000003682. Epub 2020/09/22.

    Article  PubMed  Google Scholar 

  3. Ma, Z., Huang, S., Sun, J., Li, F., Sun, J., & Pi, G. (2019). Risk factors for upper adjacent segment degeneration after multi-level posterior lumbar spinal fusion surgery. Journal of Orthopaedic Surgery and Research, 14(1), 89. https://doi.org/10.1186/s13018-019-1126-9. Epub 2019/03/30.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Stoll, T. M., Dubois, G., & Schwarzenbach, O. (2002). The dynamic neutralization system for the spine: a multi-center study of a novel non-fusion system. European Spine Journal, 11(Suppl 2), S170–S178. https://doi.org/10.1007/s00586-002-0438-2. Epub 2002/10/18.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Fay, L. Y., Wu, J. C., Tsai, T. Y., Tu, T. H., Wu, C. L., Huang, W. C., & Cheng, H. (2023). Intervertebral disc rehydration after lumbar dynamic stabilization: magnetic resonance image evaluation with a mean followup of four years. Advances in Orthopedics, 2013, 437570. https://doi.org/10.1155/2013/437570. Epub 2013/06/06.

    Article  Google Scholar 

  6. Fay, L. Y., Wu, J. C., Tsai, T. Y., Wu, C. L., Huang, W. C., & Cheng, H. (2013). Dynamic stabilization for degenerative spondylolisthesis: evaluation of radiographic and clinical outcomes. Clinical Neurology and Neurosurgery, 115(5), 535–541. https://doi.org/10.1016/j.clineuro.2012.05.036. Epub 2012/06/26.

    Article  PubMed  Google Scholar 

  7. Zhang, Y., Shan, J. L., Liu, X. M., Li, F., Guan, K., & Sun, T. S. (2016). Comparison of the dynesys dynamic stabilization system and posterior lumbar interbody fusion for lumbar degenerative disease. PLoS ONE, 11(1), e0148071. https://doi.org/10.1371/journal.pone.0148071. Epub 2016/01/30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Zhang, Y., Zhang, Z. C., Li, F., Sun, T. S., Shan, J. L., Guan, K., Zhao, G. M., & Zhang, L. Z. (2018). Long-term outcome of dynesys dynamic stabilization for lumbar spinal stenosis. Chinese Medical Journal (England), 131(21), 2537–2543. https://doi.org/10.4103/0366-6999.244107. Epub 2018/11/02.

    Article  Google Scholar 

  9. Schwarzenbach, O., & Berlemann, U. (2010). Dynamic posterior stabilization with the pedicle screw system DYNESYS(R). Operative Orthopädie und Traumatologie, 22(5–6), 545–557. https://doi.org/10.1007/s00064-010-1007-1. Epub 2010/12/15.

    Article  PubMed  Google Scholar 

  10. Jentzsch, T., Geiger, J., Zimmermann, S. M., Slankamenac, K., Nguyen-Kim, T. D., & Werner, C. M. (2013). Lumbar facet joint arthritis is associated with more coronal orientation of the facet joints at the upper lumbar spine. Radiology Research and Practice, 2013, 693971. https://doi.org/10.1155/2013/693971. Epub 2013/11/22.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Linov, L., Klindukhov, A., Li, L., & Kalichman, L. (2013). Lumbar facet joint orientation and osteoarthritis: a cross-sectional study. Journal of Back and Musculoskeletal Rehabilitation, 26(4), 421–426. https://doi.org/10.3233/BMR-130401. Epub 2013/08/21.

    Article  PubMed  Google Scholar 

  12. Chung, S. B., Lee, S., Kim, H., Lee, S. H., Kim, E. S., & Eoh, W. (2012). Significance of interfacet distance, facet joint orientation, and lumbar lordosis in spondylolysis. Clinical Anatomy, 25(3), 391–397. https://doi.org/10.1002/ca.21222. Epub 2011/08/05.

    Article  PubMed  Google Scholar 

  13. Rankine, J. J., & Dickson, R. A. (2010). Unilateral spondylolysis and the presence of facet joint tropism. Spine (Phila Pa 1976), 35(21), E1111–E1114. https://doi.org/10.1097/BRS.0b013e3181de8b72. Epub 2010/09/15.

    Article  PubMed  Google Scholar 

  14. Miyazaki, M., Morishita, Y., Takita, C., Yoshiiwa, T., Wang, J. C., & Tsumura, H. (2010). Analysis of the relationship between facet joint angle orientation and lumbar spine canal diameter with respect to the kinematics of the lumbar spinal unit. Journal of Spinal Disorders & Techniques, 23(4), 242–248. https://doi.org/10.1097/BSD.0b013e3181a8123e. Epub 2010/01/14.

    Article  Google Scholar 

  15. Qian, J., Bao, Z., Li, X., Zou, J., & Yang, H. (2016). Short-term therapeutic efficacy of the isobar TTL dynamic internal fixation system for the treatment of lumbar degenerative disc diseases. Pain Physician, 19(6), E853–E861. Epub 2016/07/28.

    PubMed  Google Scholar 

  16. Grob, D., Benini, A., Junge, A., & Mannion, A. F. (2005). Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years. Spine (Phila Pa 1976), 30(3), 324–331. https://doi.org/10.1097/01.brs.0000152584.46266.25. Epub 2005/02/01.

    Article  PubMed  Google Scholar 

  17. Cakir, B., Ulmar, B., Koepp, H., Huch, K., Puhl, W., & Richter, M. (2003). Posterior dynamic stabilization as an alternative for dorso-ventral fusion in spinal stenosis with degenerative instability. Zeitschrift für Orthopädie und ihre Grenzgebiete, 141(4), 418–424. https://doi.org/10.1055/s-2003-41568. Epub 2003/08/21.

    Article  CAS  PubMed  Google Scholar 

  18. Huang, W., Warner, M., Sasaki, H., Furukawa, K. S., & Ushida, T. (2020). Layer dependence in strain distribution and chondrocyte damage in porcine articular cartilage exposed to excessive compressive stress loading. Journal of the Mechanical Behavior of Biomedical Materials, 112, 104088. https://doi.org/10.1016/j.jmbbm.2020.104088. Epub 2020/09/30.

    Article  CAS  PubMed  Google Scholar 

  19. Fay, L. Y., Chang, P. Y., Wu, J. C., Huang, W. C., Wang, C. H., Tsai, T. Y., Tu, T. H., Chang, H. K., Wu, C. L., & Cheng, H. (2016). Dynesys dynamic stabilization-related facet arthrodesis. Neurosurgical Focus, 40(1), E4. https://doi.org/10.3171/2015.10.FOCUS15404. Epub 2016/01/02.

    Article  PubMed  Google Scholar 

  20. Majd, M., Kube, R., & Holt, R. (2008). Dynesys as a dynamic stabilization device: does it preserve lumbar motion? The Spine Journal, 8(5), 111–114.

    Article  Google Scholar 

  21. Beastall, J., Karadimas, E., Siddiqui, M., Nicol, M., Hughes, J., Smith, F., & Wardlaw, D. (2007). The Dynesys lumbar spinal stabilization system: a preliminary report on positional magnetic resonance imaging findings. Spine (Phila Pa 1976), 32(6), 685–690. https://doi.org/10.1097/01.brs.0000257578.44134.fb. Epub 2007/04/07.

    Article  PubMed  Google Scholar 

  22. Fayyazi, A. H., Ordway, N. R., Park, S. A., Fredrickson, B. E., Yonemura, K., & Yuan, H. A. (2010). Radiostereometric analysis of postoperative motion after application of dynesys dynamic posterior stabilization system for treatment of degenerative spondylolisthesis. Journal of Spinal Disorders & Techniques, 23(4), 236–241. https://doi.org/10.1097/BSD.0b013e3181a4bb0b. Epub 2010/01/15.

    Article  Google Scholar 

  23. Wurgler-Hauri, C. C., Kalbarczyk, A., Wiesli, M., Landolt, H., & Fandino, J. (2008). Dynamic neutralization of the lumbar spine after microsurgical decompression in acquired lumbar spinal stenosis and segmental instability. Spine (Phila Pa 1976), 33(3), E66-72. https://doi.org/10.1097/BRS.0b013e31816245c0. Epub 2008/02/28.

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Author notes

  1. Lei Miao and Bo Jin contributed equally to this work.

Authors and Affiliations

  1. Department of Spinal Orthopedics, People’s Hospital of Ningxia Hui Autonomous Region, 301 North Zhengyuan Road, Yinchuan, 750002, Ningxia, China

    Lei Miao, Bo Jin, Ma Ning, Zhaowei Wang, Ruopeng Mai, Lijun Cai & Yinong Wang

  2. Department of Pharmacy, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China

    Xi Zhang

  3. The Third School of Clinical Medicine, Ningxia Medical University, Ningxia, China

    Zhaowei Wang

Authors
  1. Lei Miao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bo Jin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ma Ning
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xi Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zhaowei Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ruopeng Mai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lijun Cai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yinong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ma Ning.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee of the People’s Hospital of Ningxia Hui Autonomous Region, China on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed consent

Informed consent was obtained from all patients for being included in the study.

Consent for publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miao, L., Jin, B., Ning, M. et al. The Effect of Unintended Facet Arthrodesis on the Treatment Outcome of Dynamic Neutralization System for Lumbar Degenerative Diseases. JOIO 58, 271–277 (2024). https://doi.org/10.1007/s43465-023-01088-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-023-01088-x

Keywords

Search

Navigation