Abstract
Introduction: In this study we report our experience with the clinical outcomes following Dynesys. Our objectives are to revalidate the most suitable indication(s) of Dyne-sys in patients with backpain.
Method: A prospective cohort study on 374 consecutive patients who had Dynesys for backpain from September 2000 to-present. Average age of patients was 57 years and male to female ratio were (40%:60%). Preoperative assessment involved ODI, SF36, VAS for leg and backpain and the diagnosis was confirmed with physical examination, x rays, spinal probe and lumbar spine MRI. Regular follow up was arranged at 2 weeks, 3, 6 and 12 months then on annual intervals.
In our cohort, clinical indications were:
| • Degenerative Disc Disease (DDD) | 271 patients |
| • Spondylolisthesis | 55 patients |
| • Adjacent segment disease (ASD) | 30 patients |
| • Spinal canal stenosis | 18 patients |
t-test was used for comparison between preoperative and postoperative scores and p-value was used to show the significance.
Results: Overall outcome assessment revealed significant improvement in ODI, SF36 and VAS in comparison with preoperative status (p-value < 0.05). Improvement was greatest in DDD group and average for ASD.
Patients with stenosis performed better when the procedure involved adjunct decompression. Similarly, results of decompression and fusion were better than Dynesys alone in patients with spondylolisthesis.
Discussion and Conclusion:
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Dynesys was successfully controlled symptoms of DDD in the intermediate term.
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Dynesys can be used as surgical treatment for symptomatic ASD.
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Dynesys alone in the treatment of spondylolysthesis resulted in a 45% re-operation rate, and we believe it should not be recommended as an indication.
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Dynesys alone is not recommended as a treatment for symptomatic spinal stenosis.
Correspondence should be addressed to SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
