Turkish Neurosurgery
Complications of 2-level dynamic stabilization
Mert Ciplak1, Tuncer Suzer1, Salim Senturk1, Onur Yaman1, Mehdi Sasani1, Tunc Oktenoglu1, Atilla Yilmaz2, Deniz Ufuk Erbulut3, Ali Fahir Özer1
1Koc University School of Medicine, Department of Neurosurgery, Istanbul,
2Mustafa Kemal University, Department of Neurosurgery, Hatay,
3Medipol University, Department of Neurosurgery, Istanbul,
DOI: 10.5137/1019-5149.JTN.21036-17.1

Aim: A retrospective chart and a radiographic review. Evaluation of postoperative complications, clinical improvements and radiological parameters in patients who underwent surgery using a dynamic system for 2-level lumbar stabilization. We aimed to investigate the postoperative complications, such as screw loosening, screw breakage and ASD, in patients who underwent surgery with 2-level dynamic stabilization systems. Materials and Methods: Dynamic lumbar systems enable the stabilization of unstable degenerative spines, while preventing fusion-related complications, such as adjacent segment disease(ASD) and pseudarthrosis. In our study a total of 103 patients with lumbar degenerative spinal instability underwent 2-level dynamic stabilization. Clinical findings were reviewed at a 2-year follow-up. Screw breakage and loosening were evaluated during this duration together with clinical findings. Results: Visual analog scale(VAS) and Oswestry Disability Index(ODI) scores significantly decreased at the four-month evaluation, and they were also decreased at the 1-year follow up and at the 24th postoperative month. Adjacent segment disease 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. The complication rate of 2-level of dynamic stabilization was high in this study. Conclusions: Our results showed that complications (screw loosening or breakage and adjacent segment disease) are not rare after using the 2-level dynamic stabilization system, 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.

Corresponding author : Ali Fahir Özer