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Pedicle-Based Non-fusion Stabilization Devices: A Critical Review and Appraisal of Current Evidence

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Advances and Technical Standards in Neurosurgery

Part of the book series: Advances and Technical Standards in Neurosurgery ((NEUROSURGERY,volume 41))

Abstract

Over the last decades, spinal fusion has become one of the most important principles in surgical treatment of spinal pathologies. Despite the undoubted benefits of fusion surgery, there are several drawbacks associated with this technique, including adjacent segment degeneration and pseudoarthrosis. Based on biomechanical data, dynamic stabilization of the spine is intended to ameliorate adjacent level degeneration by stabilizing vertebral motion in defined planes and mimicking natural spine movements.

In this paper, we review the literature and discuss past and present pedicle-based non-fusion dynamic stabilization devices. Although there is a paucity of high-quality prospective trials, studies have indicated both promising and disappointing results. In comparison to 360° fusion surgery, the perioperative risk seems to be lower. Other complications like screw loosening, however, have been reported with various systems, while a reduction of adjacent segment disease has not yet been demonstrated. The necessary degree of restabilization to achieve pain-free motion seems to vary greatly between patients and current systems are far from perfection. If these problems can be solved, dynamic stabilization may nevertheless be an important option of spinal surgery in the future.

The authors declare that there are no conflicts of interest and no funds have been received in support of this paper. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Neurosurgery, Medical University Innsbruck, Anichstrasse 35, A-6020, Innsbruck, Austria

    Jochen Obernauer MD, Pujan Kavakebi MD, Sebastian Quirbach MD & Claudius Thomé MD

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  1. Jochen Obernauer MD
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  2. Pujan Kavakebi MD
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  3. Sebastian Quirbach MD
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  4. Claudius Thomé MD
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Correspondence to Claudius Thomé MD .

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Editors and Affiliations

  1. Neurochirurgische Klinik, Univ.Klinikum Bonn Med. Einrichtungen, Bonn, Germany

    Johannes Schramm

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Obernauer, J., Kavakebi, P., Quirbach, S., Thomé, C. (2014). Pedicle-Based Non-fusion Stabilization Devices: A Critical Review and Appraisal of Current Evidence. In: Schramm, J. (eds) Advances and Technical Standards in Neurosurgery. Advances and Technical Standards in Neurosurgery, vol 41. Springer, Cham. https://doi.org/10.1007/978-3-319-01830-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-01830-0_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-01829-4

  • Online ISBN: 978-3-319-01830-0

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