Abstract
Aim: To investigate the use of the Graf Dynamic Stabilisation System for the treatment of multi-level discogenic pain associated with symptoms of ‘instability’.
Introduction: Indications for the use of the Graf Ligament system remain controversial. There is a small group of patients who present with severely disabling pain with failed conservative treatment, of discogenic origin at more than one level, and associated with symptoms of so-called ‘instability’ (acute pain related to position and movement), for whom treatment is extremely difficult.
Methods: Twenty-two consecutive adult patients of working age with this clinical picture, with discogenic pain at two or three levels confirmed by discography, were treated with the Graf Ligament System. They were prospectively studied, and reviewed by an independent assessor.
Results: At an average of three year follow up, 50% had good or excellent results including return to work, 18% fair, and 32% were no better. None were worse. Correlation with pre-operative MRI findings and complications will be discussed.
Conclusions: Whilst such dynamic systems may have a role in the treatment of discogenic pain, the success rate in this series does not justify its continued use for this indication without further research into the theoretical basis of the action of such dynamic stabilisation systems and the entry of all cases into prospective controlled trials.
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
