Turkish Neurosurgery 2018 , Vol 28 , Num 5
Complications of 2-Level Dynamic Stabilization: A Correlative Clinical and Radiological Analysis at Two-Year Follow-up on 103 Patients
Necati Mert CIPLAK1,Tuncer SUZER1,Salim SENTURK1,Onur YAMAN1,Mehdi SASANI1,Tunc OKTENOGLU1,Atilla YILMAZ2,Deniz Ufuk ERBULUT3,Ali Fahir ÍZER1
1Koc University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey
2Mustafa Kemal University, School of Medicine, Department of Neurosurgery, Hatay, Turkey
3Medipol University, Department of Biomedical Engineering, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.21036-17.1 AIM: To investigate the postoperative complications, such as screw loosening, screw breakage and adjacent segment disease (ASD), in patients who underwent surgery with 2-level dynamic stabilization systems.

MATERIAL and METHODS: Postoperative complications, clinical improvements and radiological parameters in patients who underwent surgery using a dynamic system for 2-level lumbar stabilization were retrospectively reviewed. A total of 103 patients with lumbar degenerative spinal instability underwent 2-level dynamic stabilization. Clinical findings were reviewed at 2-year followup. Screw breakage and loosening were evaluated during this duration together with clinical findings.

RESULTS: Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were significantly decreased at the four-month evaluation, and they were also decreased at the 1-year follow up and at the 24th postoperative month. ASD was diagnosed in twelve (8 females, 4 males) of the 103 patients in the follow-up radiological and clinical controls. There were 9 screw breakages and 4 screw loosening cases. The complication rate of 2-level dynamic stabilization was high in this study.

CONCLUSION: Our results showed that complications (screw loosening or breakage and adjacent segment disease) are not rare after 2-level dynamic stabilization, unlike the acceptable results with the single-level dynamic system. The most probable explanation is that the instrument system behaves more rigidly with every additional segment. Keywords : Dynamic rod, Dynamic stabilization, Dynamic system, Hinged screw, Lumbar degenerative disease

Corresponding author : Ali Fahir OZER, alifahirozer@gmail.com