ArticleJournal of Korean Neurosurgical Society2015
The Change of Sagittal Alignment of the Lumbar Spine after Dynesys Stabilization and Proposal of a Refinement.
Article in Journal of Korean Neurosurgical Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Comparison between Dynamic Stabilization and Instrumented Fusion in the Treatment of Spinal Stenosis with Degenerative Lumbar Scoliosis.Pain research & management · 2022Article
- MDCT-Based Finite Element Analysis for the Prediction of Functional Spine Unit Strength-An In Vitro Study.Materials (Basel, Switzerland) · 2021Article
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5 authors.
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Abstract
objectiveDynesys® is one of the pedicle-based dynamic lumbar stabilization systems and good clinical outcome has been reported. However, the cylindrical spacer between the heads of the screws undergoes deformation during assembly of the system. The pre-strain probably change the angle of instrumented spine with time and oblique-shaped spacer may reduce the pre-strain. We analyzed patients with single-level stabilization with Dynesys® and simulated oblique-shaped spacer with finite element (FE) model analysis.
methodsConsecutive 14 patients, who underwent surgery for single-level lumbar spinal stenosis and were followed-up more than 24 months (M : F=6 : 8; age, 58.7±8.0 years), were analyzed. Lumbar lordosis and segmental angle at the index level were compared between preoperation and postoperative month 24. The von Mises stresses on the obliquely-cut spacer (5°, 10°, 15°, 20°, 25°, and 30°) were calculated under the compressive force of 400 N and 10 Nm of moment with validated FE model of the L4-5 spinal motion segment with segmental angle of 16°.
resultsLumbar lordosis was not changed, while segmental angle was changed significantly from -8.1±7.2° to -5.9±6.7° (p<0.01) at postoperative month 24. The maximum von Mises stresses were markedly decreased with increased angle of the spacer up to 20°. The stress on the spacer was uneven with cylindrical spacer but it became even with the 15° oblique spacer.
conclusionThe decreased segmental lordosis may be partially related to the pre-strain of Dynesys. Further clinical and biomechanical studies are required for relevant use of the system.
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