Biomechanics of Posterior Dynamic Stabilization Systems

Spinal rigid instrumentations have been used to fuse and stabilize spinal segments as a surgical treatment for various spinal disorders to date. This technology provides immediate stability after surgery until the natural fusion mass develops. At present, rigid fixation is the current gold standard in surgical treatment of chronic back pain spinal disorders. However, such systems have several drawbacks such as higher mechanical stress on the adjacent segment, leading to long-term degenerative changes and hypermobility that often necessitate additional fusion surgery. Dynamic stabilization systems have been suggested to address adjacent segment degeneration, which is considered to be a fusion-associated phenomenon. Dynamic stabilization systems are designed to preserve segmental stability, to keep the treated segment mobile, and to reduce or eliminate degenerative effects on adjacent segments. This paper aimed to describe the biomechanical aspect of dynamic stabilization systems as an alternative treatment to fusion for certain patients.

[1]  G. Simonetti,et al.  Lumbar Spinal Stenosis Minimally Invasive Treatment with Bilateral Transpedicular Facet Augmentation System , 2013, Cardiovascular and Interventional Radiology.

[2]  Z. Smith,et al.  A minimally invasive technique for percutaneous lumbar facet augmentation: Technical description of a novel device , 2011, Surgical neurology international.

[3]  E. Ebramzadeh,et al.  Comparison of Three Posterior Dynamic Stabilization Devices , 2011, Spine.

[4]  Jon Park,et al.  Lumbar disc rehydration postimplantation of a posterior dynamic stabilization system. , 2010, Journal of neurosurgery. Spine.

[5]  A. Alpízar-Aguirre,et al.  Posterior dynamic stabilization of the lumbar spine with the Accuflex rod system as a stand-alone device: experience in 20 patients with 2-year follow-up , 2010, European Spine Journal.

[6]  N. Crawford,et al.  Dynamic Lumbar Pedicle Screw-Rod Stabilization: Two-Year Follow-Up and Comparison with Fusion , 2010, The open orthopaedics journal.

[7]  H. Halm,et al.  Does an interspinous device (Coflex™) improve the outcome of decompressive surgery in lumbar spinal stenosis? One-year follow up of a prospective case control study of 60 patients , 2010, European Spine Journal.

[8]  C. Stüer,et al.  Pedicle screw-based dynamic stabilization of the thoracolumbar spine with the Cosmic®-system: a prospective observation , 2010, Acta Neurochirurgica.

[9]  Hendrik Schmidt,et al.  Prospective Design Delineation and Subsequent In Vitro Evaluation of a New Posterior Dynamic Stabilization System , 2009, Spine.

[10]  Hendrik Schmidt,et al.  Which axial and bending stiffnesses of posterior implants are required to design a flexible lumbar stabilization system? , 2009, Journal of biomechanics.

[11]  A. Strempel Dynamic stabilisation: cosmic system , 2008 .

[12]  Qing Hang Zhang,et al.  Finite element application in implant research for treatment of lumbar degenerative disc disease. , 2008, Medical engineering & physics.

[13]  T. Wright,et al.  Use of instrumented pedicle screws to evaluate load sharing in posterior dynamic stabilization systems. , 2008, The spine journal : official journal of the North American Spine Society.

[14]  Christof Hurschler,et al.  The effect of dynamic, semi-rigid implants on the range of motion of lumbar motion segments after decompression , 2008, European Spine Journal.

[15]  Justin Hughes,et al.  The Dynesys Lumbar Spinal Stabilization System: A Preliminary Report on Positional Magnetic Resonance Imaging Findings , 2007, Spine.

[16]  M. Kaiser,et al.  Posterior dynamic stabilization of the lumbar spine: pedicle based stabilization with the AccuFlex rod system. , 2007, Neurosurgical focus.

[17]  G. Bergmann,et al.  Comparison of the effects of bilateral posterior dynamic and rigid fixation devices on the loads in the lumbar spine: a finite element analysis , 2007, European Spine Journal.

[18]  R. Schmidt,et al.  Dynamic stabilization of the lumbar spine. , 2006, Orthopedics.

[19]  Dimitriy Kondrashov,et al.  Interspinous Process Decompression With the X-STOP Device for Lumbar Spinal Stenosis: A 4-Year Follow-Up Study , 2006, Journal of spinal disorders & techniques.

[20]  Douglas Wardlaw,et al.  Effects of X-Stop Device on Sagittal Lumbar Spine Kinematics in Spinal Stenosis , 2006, Journal of spinal disorders & techniques.

[21]  A. Patwardhan,et al.  Test protocols for evaluation of spinal implants. , 2006, The Journal of bone and joint surgery. American volume.

[22]  Thomas R. Oxland,et al.  Biomechanical characterization of the three-dimensional kinematic behaviour of the Dynesys dynamic stabilization system: an in vitro study , 2006, European Spine Journal.

[23]  L. Claes,et al.  Influence of a dynamic stabilisation system on load bearing of a bridged disc: an in vitro study of intradiscal pressure , 2006, European Spine Journal.

[24]  R. Fessler,et al.  Dynamic Interspinous Process Technology , 2005, Spine.

[25]  K. Shigenobu,et al.  Rationale, biomechanics, and surgical indications for Graf ligamentoplasty. , 2005, The Orthopedic clinics of North America.

[26]  O. Schwarzenbach,et al.  Posterior dynamic stabilization systems: DYNESYS. , 2005, The Orthopedic clinics of North America.

[27]  S. Yerby,et al.  The Effects of an Interspinous Implant on the Kinematics of the Instrumented and Adjacent Levels in the Lumbar Spine , 2003, Spine.

[28]  L Claes,et al.  Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment. , 2003, Journal of spinal disorders & techniques.

[29]  J. Sénégas,et al.  Mechanical supplementation by non-rigid fixation in degenerative intervertebral lumbar segments: the Wallis system , 2002, European Spine Journal.

[30]  K. Yamamoto,et al.  Mid-term clinical results of Graf stabilization for lumbar degenerative pathologies. a minimum 2-year follow-up. , 2001, The spine journal : official journal of the North American Spine Society.

[31]  P. Fennema,et al.  Dynamic Neutralization: A New Concept for Restabilization of the Spine , 1999 .