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Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis

  • Clinical Article - Spine
  • Published:
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An Erratum to this article was published on 09 February 2014

Abstract

Background

Different treatment options exist for symptomatic single-level degenerative anterolisthesis and stenosis. While simple micro-decompression has been advocated lately, most authors recommend posterior decompression with fusion. In recent years, decompression and dynamic transpedicular stabilisation has been introduced for this indication. The aim of this study was to evaluate the safety and efficacy of decompression and dynamic transpedicular stabilisation with the Dynesys® system in single-level degenerative anterolisthesis and stenosis.

Methods

Thirty consecutive patients with symptomatic single-level degenerative anterolisthesis and stenosis without scoliosis underwent decompression and single-level Dynesys stabilisation at the level of degenerative anterolisthesis. Patients were followed prospectively for 24 months with radiographs, Oswestry Disability Index scores, visual analogue scale (VAS) for back and leg pain, and estimated pain-free walking distance.

Results

At the 2-year follow-up, back pain was reduced from 6.5 preoperatively to 2.5, leg pain from 5.4 to 0.6. The pain-free walking distance was estimated at 500 m preoperatively and at over 2 km after 2 years, while the ODI decreased from 54 % to 18 %. Screw loosening was found in 2/30 cases. Symptomatic adjacent segment disease was found in 3/30 patients between 12 and 24 months postoperatively.

Conclusions

Single-level Dynesys stabilisation combined with single- or multi-level decompression seems to be a safe and efficient treatment option in single-level degenerative anterolisthesis and stenosis over an observation period of 2 years, avoiding iliac crest or local bone grafting required by fusion procedures. However, it does not seem to avoid adjacent segment disease.

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Conflicts of interest

None.

Disclaimer

The authors declare that they did not and will not receive any benefits from the implant company (Zimmer) or any other party for this study.

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Authors and Affiliations

  1. Neurosurgical Department, Hirslanden Klinik, Zürich, Switzerland

    Michael Payer

  2. Neurosurgical Department, University of Geneva, Geneva, Switzerland

    Michael Payer & Enrico Tessitore

  3. Department of Surgery, Frankston Hospital, Frankston, Victoria, Australia

    Smoll Nicolas

  4. Neurosurgical Department, Universitätsklinikum Essen, Essen, Germany

    Neriman Oezkan

  5. Klinik Hirslanden, Witellikerstrasse 40, 8032, Zürich, Switzerland

    Michael Payer

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  1. Michael Payer
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  2. Smoll Nicolas
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Correspondence to Michael Payer.

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Payer, M., Nicolas, S., Oezkan, N. et al. Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis. Acta Neurochir 156, 221–227 (2014). https://doi.org/10.1007/s00701-013-1956-x

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  • DOI: https://doi.org/10.1007/s00701-013-1956-x

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