Abstract
Spinal fusion still is considered to be the most appropriate treatment for lumbar spinal disease not responding to conservative measures. Various forms of lumbar instability require surgical stabilisation. As an alternative to fusion, mobile, dynamic stabilisation restricting segmental motion would be advantageous under certain conditions, allowing greater physiological function and reducing the inherent disadvantages of rigid instrumentation and fusion. The “Dynamic Neutralization System for thèeSpine” is a pedicle screw system for mobile stabilisation, consisting of titanium alloy screws connected by an elastic synthetic compound, controlling motion in any plane (non-fusion system). Clinical success after solid fusion is unpredictable because it does not necessarily prevent painful loading across the disc, and it may also interfere with maintenance of sagittal balance in various postures. This system reduces movement both in flexion and extension and appears to be better. These study results compare well with those obtained by conventional procedures; in addition to which, mobile stabilisation is less invasive than fusion. Long-term screw fixation is dependent on correct screw dimensions and proper screw positioning. The natural course of polysegmental disease in some cases necessitates further surgery as the disease progresses. Dynamic neutralisation proved to be a safe and effective alternative in the treatment of unstable lumbar conditions.
