TWO YEARS OUTCOME FOLLOWING DYNAMIC NEUTRALISATION SYSTEM FOR THE TREATMENT OF SPINAL CANAL STENOSIS

Abstract

Introduction: We report the outcome two years following Dynesys for the treatment of Spinal Canal Stenosis. In both the FDA trial and the European multicentre study, stenosis was invariably combined with decompression, invalidating conclusions on the results of Dynesys alone.

Method: Eighteen patients had symptomatic Spinal Canal Stenosis with root claudication sufficient to justify surgical intervention. Average age of patients was 68 with a range between 44–86 years. Dynesys was applied for the treatment of a single level in 4, two levels in 8, and more than two levels in 6.

Patients were evaluated preoperatively using ODI, SF36, VAS, plain x-ray, MRI scanning & discography. Questionnaires were evaluated at the first and second years.

Results: 2 patients had undergone previous spinal decompression, and decompression at the time of Dynesys surgery in 7. In the remaining 9 cases, no decompression was used, relying on distraction alone as in the X stop system. In this latter group, stenotic symptoms failed to resolve. Removal of Dynesys was indicated in 3 (16.6%).

Discussion & Conclusions: Dynesys alone is not recommended as a treatment for symptomatic spinal stenosis. A separate study is required to address the question of whether Dynesys adjunct improves the back pain outcome compared with decompression alone.