Minimum Ten-Year FollowUp of Spinal Stenosis with Degenerative Spondylolisthesis Treated with Decompression and Dynamic Stabilization - Abstract
Purpose: The Dynesys system remains the most widely implanted posterior non fusion pedicle screw system. Various study designs used in investigations with good to excellent short- and mid-term results have been reported in the current literature. However there is a lack of information concerning long-term outcomes following treatment for spinal stenosis with degenerative spondylolisthesis.
Methods: The aim of our study was twofold. Firstly, to assess whether the dynamic stabilization in situ with the Dynesys system without bone grafting provides enough stability to prevent progression of spondylolisthesis and secondarily to maintain significant clinical improvement in a long-term FU. Therefore, the consecutive patients due to inclusion criterions underwent interlaminar decompression and stabilization with Dynesys instrumentation. Patients were evaluated clinically and after a minimum FU of 10 years.
Results: At FU, the mean LBP and LP on VAS and NASS improved significantly (p < 0.001) compared to preoperative examination. The mean value of NASS neurogenic symptoms (19.13% and 4.72%) and activity sub scores were 23.13% and 10.74% respectively. In plain and functional radiographs the mean listhesis grade in neutral position was 11.11%, 11.8% in reclination and 11.63% in inclination. There were 17 and 8 patients with progressing degenerative osteochondrosis/listhesis at adjacent segments.
Conclusions: Decompression and single and double level dynamic in situ stabilization with the Dynesys System demonstrate good clinical and radiological long-term results in elderly patients.