[System of dynamic neutralization in the lumbar spine: experience on 94 cases]. / Sistema de neutralización dinámica en la coluna lumbar. SISTEMA DYNESYS. Experiencia en 94 casos

OBJECTIVE: To assess the results obtained using the Dynesys system (Dynamic Neutralisation System for the spine), in a group of 94 patients. This new system for treating lumbar degenerative pathologies is based on lumbar stabilisation and preservation of articular function, as opposed to traditional arthrodesis restrictions. MATERIAL AND METHODS: We analyze series of 94 patients in whom this system was used. 62 were males and 32 females with an average age of 46.4 years. The pathologies treated were disc herniation in 27 cases, degenerative discopathy in 54 cases and lumbar channel stenosis in 13 cases. Follow-up was carried out between 14 and 24 months, assessing the clinical picture according to the Oswestry scale and the return to work. RESULTS: The final results on the Oswestry scale were 21.4% with respect to 56.8% prior to the treatment and the return to work was 82%. There was a remission of the sciatica symptoms in almost all the cases, as well as of the lumbar pain, and there was a 60% improvement in the claudication cases. With regard to complications, we would like to point out two cases due to the technique, one because of the wrong positioning of the screws and the other due to the rupture of the pedicle. There were two cases of subcutaneous seroma and two late subclinical infections. CONCLUSIONS: The dynamic neutralisation obtained using this system, should not be considered as an arthrodesis. Treatment using Dynesys enlarges the population of patients candidates for surgery to who initially do not apparently need a standard fixation, but who raise doubt regarding the application of techniques without instrumental support, incorporating the functionality concept as opposed to restricting movement. This system can be defined as a disc prosthesis fitted externally to the disc. We have obtained good results in the majority of our patients, although we believe that the follow-up should be increased.

Sistema de neutralización dinámica en la columna lumbar. SISTEMA DYNESYS Experiencia en 94 casos / System of dynamic neutralization in the lumbar spine. Experience on 94 cases

Objetivo. Valorar los resultados obtenidos con la utilización del sistema Dynesys (Dynamic Neutralización System for the spine), en un grupo de 94 pacientes, como nuevo concepto para el tratamiento de la patología degenerativa lumbar basado en la estabilización lumbar con conservación de la función articular encontrar de la restricción de la artrodesis clásica. Material y métodos. Presentamos 94 pacientes en los que se utilizó este sistema de los cuales 62 fueron hombres y 32 mujeres con una edad media de 46.4 años. La patología de los pacientes fue de hernia discal en 27casos, discopatía degenerativa en 54 casos y estenosis decanal en 13 casos. Se realizó un seguimiento entre 14 t24 meses valorando la clínica según la escala de Oswestry y la reincorporación al trabajo. Resultados. Los resultados en la escala de Oswestry fue del 21.4% definitivo con respecto al 56.8% previo al tratamiento y la reincorporación al trabajo fue del82%. El cuadro ciático ha remitido prácticamente en todos los casos, así como la lumbalgia y una mejoría del60% en casos de claudicación. Como complicaciones reseñamos dos casos debidas a la técnica, con mal posición de tornillos en un caso y rotura pedicular en otro, dos casos de seroma subcutáneo y dos infecciones subclínicastardías. Conclusiones. La neutralización dinámica obtenida mediante este sistema, no debe ser considerada como una artrodesis. El tratamiento con Dynesys amplía la población de pacientes en los que se puede intervenir a aquellos que en principio no son tributarios de una fijación estándar, pero que planteaban dudas al cirujano al aplicar técnicas sin apoyo instrumental, incorporando el concepto de funcionalidad frente a la restricción del movimiento. Se puede definir como una prótesis díscal colocada extra-discalmente. Hemos obtenido un buen resultado en la mayoría de nuestros pacientes, aunque pensamos que es preciso ampliar el tiempo de seguimiento

Objective. To assess the results obtained using the Dynesys system (Dynamic Neutralisation System for the spine), in a group of 94 patients This new system for treating lumbar degenerative pathologie is based on lumbar stabilisation and preservation of articular function, as opposed to traditional arthrodesis restrictions. Material and methods. We analyze series of 94 patients in whom this system was used. 62 were males and 32females with an average age of 46,4 years. The pathologies streated were disc herniation in 27 cases, degenerative discopathy in 54 cases and lumbar channel stenosis in 13 cases. Follow-up was carried out between 14 and24 months, assessing the clinical picture according to the Oswestry scale and the return to work. Results. The final results on the Oswestry scale were21,4% with respect to 56,8% prior to the treatment and the return to work was 82%. There was a remission of the sciatica symptoms in almost all the cases, as well as of the lumbar pain, and there was a 60% improvement in the claudication cases. With regard to complications, we would like to point out two cases due to the technique, one because of the wrong positioning of the screws and the other due to the rupture of the pedicle. There were two cases of subcutaneous seroma and two late subclinical infections. Conclusions. The dynamic neutralisation obtained using this system, should not be considered as an arthrodesis. Treatment using Dynesys enlarges the population of patients candidates for surgery to who initially do not apparently need a standard fixation, but who raise doubt regarding the application of techniques without instrumental support, incorporating the functionality concept as opposed to restricting movement. This system can be defined as a disc prosthesis fitted externally to the disc. We have obtained good results in the majority of our patients, although we believe hut the follow-up should be increased