Dynamic Stabilization is a surgical technique that is designed to allow for some movement of the spine. However, enough stability is maintained to prevent too much movement. This procedure is generally regarded as an alternative to the lumbar fusion surgery.
Dynamic stabilization of the lumbar spine involves two different types of procedures;
- One of them is a total disc replacement either in the lumbar or cervical spine.
- The other is a technology that is being developed to provide stability to a lumbar spine that is exhibiting instability. This instability must be causing intolerable and intractable low back pain.
Purpose of Dynamic Stabilization
The purpose of dynamic stabilization is to address back pain that is being caused by degenerative disc disease or facet arthropathy. Facet Arthropathy is the back pain caused by lumbar facet disease. The facets are a paired set of joints that are present at every level in the spine between the vertebrae. Dynamic stabilization devices treat pain caused by both degenerative disc and facet disease. It is done by supporting and controlling the motion around the painful segment.
Difference Between Dynamic Stabilization and Spinal Fusion Surgery
Dynamic stabilization involves placing screws into the pedicle of the vertebral body. They are placed at the level above and below the level with degenerative disc disease or facet disease. Rigid devices, such as fixed screws and titanium rods are used in spinal fusion surgery. However, the dynamic stabilization stabilization involves incorporating non-rigid devices such as bendable rods or elastic bands. These are then inserted into the pedicle screws.
The flexible connections between the screws allow some motion to take place at the diseased level. However, due to the stabilizing effect of these devices, patient should have decreased low back pain after initial healing period of surgery.
Suitability of Dynamic Stabilization
These devices are also better suited for younger patients for which a fusion surgery would take away range of motion or portend adjacent segment disease. Dynamic stabilization is not a good option for older patients with osteoporotic bone. Dynamic stabilization is also more suited for low back pain. However, the results of any surgical intervention for axial low back pain are mixed at best. At most 60% of the patients experience relief from their back pain.
Although the initial results are promising, this new technology has only short-term results on patients in the United States. The dynamic stabilization devices currently approved by FDA were approved for fusion only. Patients should consult surgeons who perform this procedure to see if they are eligible candidates. The patients should also conduct a thorough research on their own to determine if this treatment is right for them.
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