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DOS Kongressen 2016 ·
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2 years Retrospective Follow-up of Posterior
Dynamic Stabilization (Dynesys®) in lower back
pain without olistesis using patient reported
outcomes.
Niklas Tøndevold, Jamal Bouknaitir, Hassan Shakir
Ortopædkirurgisk afd, Sjællands Universitetshospital
Background:
Surgical Treatment of lower back pain in the younger patients
usually includes some kind of rigid fixation. Even some studies have shown a
near 100% fusion rate there have only been reported an average of 70% satis-
factory rates according to patient surveys. Fusion surgery has additionally some
disadvantages including stress and degeneration of the adjacent segments.
In our institution we have used semirigid dynamic fixation system (Dynesys®,
Zimmer) in younger patients with lower back pain without olistesis. The goal is
to offer pain relief without solid bone fusion.
Purpose / Aim of Study:
Using SF-36, ODI and EQ-5D we monitored the
patient satisfaction 1 and 2 years after surgery. Futhermore we examined the
reoperation and complication rate.
Materials and Methods:
From 2009 to 2013, 254 patients had a spinal fusion
in our institution. 88 patients had dynamic stabilization, 46 men and 42 females
with a mean age of 46 (20-72). None of the patients had any comorbidity. The
patients received the SF-36, EQ-5D, Oswestry lower disability questionnaire
and form asking about walking distance, usage of pain medication, work/pen-
sion status and pain evaluation back. The questionnaire where sent preopera-
tively, 1 and 2 years postoperatively.
Findings / Results:
67 of the 88 patients answered the questionnaires. In the
88 patients 9 had additional surgery. All patient reported outcomes improved
significantly after surgery.
Conclusions:
Patient satisfaction is at the same level as other studies.
Complication rates are identical. Re operations are within actable levels. No ma-
jor complications. 2 patients had adjacent level degeneration requiring surgery
and 3 had a secondary rigid fixation of the same level. The method is less trau-
matic to the posterior joints and soft tissue, and gives satisfactory results in this
young and healthy patient population.
No conflicts of interest reported
192.