Complications of 2-level dynamic stabilization: A correlative clinical and radiological analysis at two-year follow-up on 103 patients


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Ciplak N. M., Suzer T., Senturk S., Yaman O., Sasani M., Oktenoglu T., ...More

Turkish Neurosurgery, vol.28, no.5, pp.756-762, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 28 Issue: 5
  • Publication Date: 2018
  • Doi Number: 10.5137/1019-5149.jtn.21036-17.1
  • Journal Name: Turkish Neurosurgery
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.756-762
  • Keywords: Dynamic rod, Dynamic stabilization, Dynamic system, Hinged screw, Lumbar degenerative disease
  • Istanbul Medipol University Affiliated: Yes

Abstract

AIM: To investigate the postoperative complications, such as screw loosening, screw breakage and adjacent segment disease (ASD), in patients who underwent surgery with 2-level dynamic stabilization systems. MATERIAL and METHODS: Postoperative complications, clinical improvements and radiological parameters in patients who underwent surgery using a dynamic system for 2-level lumbar stabilization were retrospectively reviewed. A total of 103 patients with lumbar degenerative spinal instability underwent 2-level dynamic stabilization. Clinical findings were reviewed at 2-year followup. Screw breakage and loosening were evaluated during this duration together with clinical findings. RESULTS: Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were significantly decreased at the four-month evaluation, and they were also decreased at the 1-year follow up and at the 24th postoperative month. ASD was diagnosed in twelve (8 females, 4 males) of the 103 patients in the follow-up radiological and clinical controls. There were 9 screw breakages and 4 screw loosening cases. The complication rate of 2-level dynamic stabilization was high in this study. CONCLUSION: Our results showed that complications (screw loosening or breakage and adjacent segment disease) are not rare after 2-level dynamic stabilization, unlike the acceptable results with the single-level dynamic system. The most probable explanation is that the instrument system behaves more rigidly with every additional segment.