The Incidence of Adjacent Segment Degeneration after the Use of a Versatile Dynamic Hybrid Stabilization Device in Lumbar Stenosis: Results of a 5–8-Year Follow-up

Mauro Dobran; Davide Nasi; Domenico Paolo Esposito; Maurizio Gladi; Massimo Scerrati; Maurizio Iacoangeli

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저자정보: Mauro Dobran (Università Politecnica delle Marche) Davide Nasi (Università Politecnica delle Marche) Domenico Paolo Esposito (Università Politecnica delle Marche) Maurizio Gladi (Università Politecnica delle Marche) Massimo Scerrati (Università Politecnica delle Marche) Maurizio Iacoangeli (Università Politecnica delle Marche)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.12 No.2

발행연도: 2018.1

수록면: 263 - 271 (9page)

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Study Design: Retrospective study with long-term follow-up. Purpose: To evaluate the long-term incidence of adjacent segment degeneration (ASD) and clinical outcomes in a consecutive series of patients who underwent spinal decompression associated with dynamic or hybrid stabilization with a Flex+TM stabilization system (SpineVision, Antony, France) for lumbar spinal stenosis. Overview of Literature: The incidence of ASD and clinical outcomes following dynamic or hybrid stabilization with the Flex+TM system used for lumbar spinal stenosis have not been well investigated. Methods: Twenty-one patients with lumbar stenosis and probable post-decompressive spinal instability underwent decompressive laminectomy followed by spinal stabilization using the Flex+TM stabilization system. The indication for a mono-level dynamic stabilization was a preoperative magnetic resonance imaging (MRI) demonstrating evidence of severe disc disease associated with severe spinal stenosis. The hybrid stabilization (rigid–dynamic) system was used for multilevel laminectomies with associated initial degenerative scoliosis, first-grade spondylolisthesis, or rostral pathology. Results: The improvement in Visual Analog Scale and Oswestry Disability Index scores at follow-up were statistically significant (p <0.0001 and p <0.0001, respectively). At the 5–8-year follow-up, clinical examination, MRI, and X-ray findings showed an ASD complication with pain and disability in one of 21 patients. The clinical outcomes were similar in patients treated with dynamic or hybrid fixation. Conclusions: Patients treated with laminectomy and Flex+TM stabilization presented a satisfactory clinical outcome after 5–8 years of follow-up, and ASD incidence in our series was 4.76% (one patient out of 21). We are aware that this is a small series, but our long-term follow-up may be sufficient to contribute to the expanding body of literature on the development of symptomatic ASD associated with dynamic or hybrid fixation.

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