Ověření stabilizace degenerativních změn páteře systémem Dynesys

MUDr. Jan Cienciala, Ph.D.

Doctoral thesis

The Verification of the Stabilisation of the Lumbal Spine Degenerative Conditions by the Dynesys System

Abstract:

Autor ve své práci hodnotil 102 nemocných s diskogenní degenerativní chorobou páteře operovaných dynamickým neutralizačním systémem Dynesys. Výsledky hodnotil pomocí analogové škály bolesti VAS i Oswestry dotazníku (ODI) a dále klinickým i zobrazovacím vyšetřením. Zjistil, že metoda Dynesys má u těchto nemocných své přednosti, upravuje bolest ve škále VAS i kvalitu života ODI. Statisticky prokázal, že operace zlepší stav pacienta oproti stavu před operací. Během tří let sledování po operaci nebyl pozorován statisticky významný rozdíl ve změně stavu.

Abstract:

The author has been evaluating 102 patients with degenerative disc disease who have been operated by Dynesys. The results were analysed by both visual analog scale (VAS) and Oswestry disability index (ODI) and also by clinical and imaging assessment. The author proved the advantages of Dynesys method with these patients and the fact that this method improves the pain scale (VAS) and quality of life (ODI). According to his statistics, the clinical improvement of the patients after the operation remained the same during the following three postoperative years. 26 out of the102 patients were MRI carried out even postoperatively and the analysis proved the restoration of intervertebral disc protrusion and partly of disc height and the tension of posterior longitudinal ligament. All these changes together with the enlargement of intervertebral foramen may correlate with the improvement of postoperative pain scale. The study has not been able to prove the restoration of edematous-inflammatory changes in peridiscal marrow as a result of segmental regeneration. The experiment was carried out in cooperation with VUT in Brno, and their testing machine Zwick showed Dynesys to be an efficient procedure for stabilization, neutralization and function of the segment in comparison with Legacy rigid system. Compared to rigid fusion systems the dynamic neutralization with Dynesys enables a certain degree of freedom of intervertebral joint and protects adjacent segments againts overloading. The achievement of the demanded stability of spinal segment does not lead to the destruction of intervertebral joints. Therefore this study evaluate dynamic neutralizatizon by Dynesys system to be a beneficial method to the treatment of patients with DDD at the stages 3 to 6 according to the classification of Husson et al. and of Kirkaldy-Willis. The results are comparable with those of foreign multicentric studies.

Keywords

Lumbal spine, Surgical treatment, Non-fusion, Instrumentation, Instability

Language used: Czech

Date on which the thesis was submitted / produced: 30. 6. 2008

Thesis defence

• Date of defence: 30. 6. 2008
• Supervisor: prof. MUDr. Martin Krbec, CSc.

Masaryk University

Faculty of Medicine

Doctoral programme / field:
General Medicine / Surgery