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
Study DesignRetrospective study with long-term follow-up.PurposeTo 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 stabi...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2018-04-01
|
| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-12-263.pdf |
| _version_ | 1811319479722835968 |
|---|---|
| author | Mauro Dobran Davide Nasi Domenico Paolo Esposito Maurizio Gladi Massimo Scerrati Maurizio Iacoangeli |
| author_facet | Mauro Dobran Davide Nasi Domenico Paolo Esposito Maurizio Gladi Massimo Scerrati Maurizio Iacoangeli |
| author_sort | Mauro Dobran |
| collection | DOAJ |
| description | Study DesignRetrospective study with long-term follow-up.PurposeTo 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 LiteratureThe 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.MethodsTwenty-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.ResultsThe 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.ConclusionsPatients 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. |
| first_indexed | 2024-04-13T12:42:52Z |
| format | Article |
| id | doaj.art-9d56e09bc7f84b67acb9ea7418cd16d6 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-13T12:42:52Z |
| publishDate | 2018-04-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-9d56e09bc7f84b67acb9ea7418cd16d62022-12-22T02:46:27ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462018-04-0112226327110.4184/asj.2018.12.2.263344The 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-upMauro Dobran0Davide Nasi1Domenico Paolo Esposito2Maurizio Gladi3Massimo Scerrati4Maurizio Iacoangeli5Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.Department of Neurosurgery, Umberto I University General Hospital, Università Politecnica delle Marche, Ancona, Italy.Study DesignRetrospective study with long-term follow-up.PurposeTo 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 LiteratureThe 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.MethodsTwenty-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.ResultsThe 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.ConclusionsPatients 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.http://www.asianspinejournal.org/upload/pdf/asj-12-263.pdfAdjacent segment degenerationDynamic stabilizationHybrid stabilizationLumbar stenosis |
| spellingShingle | Mauro Dobran Davide Nasi Domenico Paolo Esposito Maurizio Gladi Massimo Scerrati Maurizio Iacoangeli 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 Asian Spine Journal Adjacent segment degeneration Dynamic stabilization Hybrid stabilization Lumbar stenosis |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Adjacent segment degeneration Dynamic stabilization Hybrid stabilization Lumbar stenosis |
| url | http://www.asianspinejournal.org/upload/pdf/asj-12-263.pdf |
| work_keys_str_mv | AT maurodobran theincidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT davidenasi theincidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT domenicopaoloesposito theincidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT mauriziogladi theincidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT massimoscerrati theincidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT maurizioiacoangeli theincidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT maurodobran incidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT davidenasi incidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT domenicopaoloesposito incidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT mauriziogladi incidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT massimoscerrati incidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup AT maurizioiacoangeli incidenceofadjacentsegmentdegenerationaftertheuseofaversatiledynamichybridstabilizationdeviceinlumbarstenosisresultsofa58yearfollowup |