Use of Dynamic Spinal Instruments (Dynesys) in Adult Spinal Deformities According to Silva-Lenke and Berjano-Lamartina Classifications.

Autor: Akgun MY; Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey.; Spine Center, Koc University Hospital, 34010 Istanbul, Turkey., Ucar EA; Medical Faculty, Koc Univesity School of Medicine, 34010 Istanbul, Turkey., Gedik CC; Department of Orthopaedics and Traumatology, Koc University Hospital, 34010 Istanbul, Turkey., Gunerbuyuk C; Spine Center, Koc University Hospital, 34010 Istanbul, Turkey.; Department of Orthopaedics and Traumatology, Koc University Hospital, 34010 Istanbul, Turkey., Hekimoglu M; Department of Neurosurgery, American Hospital, 34010 Istanbul, Turkey., Cerezci O; Department of Physical Medicine and Rehabilitation, American Hospital, 34010 Istanbul, Turkey., Oktenoglu T; Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey.; Spine Center, Koc University Hospital, 34010 Istanbul, Turkey., Sasani M; Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey.; Spine Center, Koc University Hospital, 34010 Istanbul, Turkey., Ates O; Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey.; Spine Center, Koc University Hospital, 34010 Istanbul, Turkey., Ozer AF; Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey.; Spine Center, Koc University Hospital, 34010 Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2024 Mar 05; Vol. 14 (5). Date of Electronic Publication: 2024 Mar 05.
DOI: 10.3390/diagnostics14050549
Abstrakt: Background: Adult spinal deformities (ASD) present complex challenges in spine surgery. The diverse nature of these deformities requires a comprehensive understanding of their classification and treatment options. Traditional approaches, such as fusion and rigid stabilization are associated with complications, including screw loosening, breakage, proximal junctional kyphosis (PJK), and pseudoarthrosis. Dynamic stabilization techniques have emerged as promising alternatives, to reduce these complications and preserve spinal motion.
Objective: This study investigated the effectiveness of dynamic stabilization using the Dynesys system in the surgical treatment of adult degenerative spinal deformities, with a particular emphasis on their classification.
Methods: ASDs were classified according to the Berjano-Lamartina (BL) and Silva-Lenke (SL) classifications. We analyzed the efficacy of the Dynesys system in enhancing sagittal balance, radiological parameters, and clinical outcomes in this context.
Results: Dynamic stabilization of patients with ASDs using the Dynesys system significantly improved the visual analog scale and Oswestry Disability Index scores and decreased the complication rates. Patients with BL types 2, 3, and 4 experienced a significant improvement in sagittal balance followed by sagittal vertical axis measurements ( p = 0.045, p = 0.015, and p < 0.0001, respectively).
Conclusion: The SL and BL classifications, which were originally developed for rigid spinal stabilization, can be applied in dynamic stabilization. Furthermore, dynamic stabilization using the Dynesys system can be used as an alternative to rigid stabilization in SL levels 2 and 3, and BL types 1, 2, and 3, and in some patients with type 4 ASDs.
Databáze: MEDLINE
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