Stabilization of the lumbar spine using the dynamic neutralization system.

Abstract

The records of 68 patients (42 men and 26 women) who underwent spine stabilization with a dynamic neutralization system were reviewed. Mean patient age at operation was 42.8 years. The primary indication for surgery was degenerative spine disease and instability with neurogenic or radicular pain and/or chronic back pain. Forty-one (60.2%) patients had degenerative diskopathy or disk herniation, and 27 (39.8%) patients had lumbar spine stenosis. One-motion segment spine stabilization was performed in 30 patients, 2-motion segment spine stabilization in 32 patients, and 3-motion segment spine stabilization in 6 patients. Within a mean follow-up of 36.2 months (range, 12.9-75.3 months), there were 2 re-operations, and 3 patients with screw loosening. Re-operations were for a deep infection in 1 patient and left leg pain in another patient. Both patients were managed with early implant removal and spinal arthrodesis. Self-assessment questionnaires showed improvement of patients' clinical and functional status. The Oswestry Disability Index and the Roland-Morris Disability Questionnaire score improved from a mean preoperative score of 55.4% (severe disability) and 52% respectively to a mean postoperative score of 22.9% (moderate disability) and 35% respectively. The overall results of this study are highly comparable to fusion procedures. The dynamic neutralization system can be a safe and effective alternative technique to spine arthrodesis in selected cases of degenerative lumbar spine instability.