OBJECTIVE The development of symptomatic @entity1347 ( @entity1347 ) is a well-recognized consequence of lumbar fusion surgery. Extension of a fusion to a diseased segment may only lead to subsequent adjacent-segment degeneration. The authors report the use of a novel technique that uses dynamic stabilization instead of arthrodesis for the surgical treatment of symptomatic @entity1347 following a prior lumbar instrumented fusion. METHODS A cohort of 28 consecutive @entity1 was evaluated who developed symptomatic @entity850 immediately adjacent to a previous lumbar instrumented fusion. All @entity1 had symptoms of @entity613 refractory to nonsurgical treatment and were surgically treated with decompression and dynamic stabilization instead of extending the fusion construct using a posterior lumbar dynamic stabilization system. Preoperative symptoms, visual analog scale (VAS) @entity158 scores, and perioperative complications were recorded. Clinical outcome was gauged by comparing VAS scores prior to surgery and at the time of last follow-up. RESULTS The mean follow-up duration was 52 months (range 17-94 months). The mean interval from the time of primary fusion surgery to the dynamic stabilization surgery was 40 months (range 10-96 months). The mean @entity1 age was 51 years (range 29-76 years). There were 19 (68%) @entity1 and 9 (32%) @entity1 . Twenty-three @entity1 (82%) presented with @entity1643 at time of surgery, whereas 24 @entity1 (86%) presented with lower-extremity symptoms only. Twenty-four @entity1 (86%) underwent operations that were performed using single-level dynamic stabilization, 3 @entity1 (11%) were treated at 2 levels, and 1 @entity1 underwent 3-level decompression and dynamic stabilization. The most commonly affected and treated level (46%) was @entity6357 . The mean preoperative VAS @entity158 score was 8, whereas the mean postoperative score was 3. No @entity1 required surgery for symptomatic degeneration rostral to the level of dynamic stabilization during the follow-up period. CONCLUSIONS The use of posterior lumbar dynamic stabilization may offer a valid and safe option for the management of @entity1 who develop @entity1347 rostral to a previously instrumented arthrodesis. The technique may serve as an alternative to multilevel arthrodesis in this @entity1 population. By implanting a dynamic stabilization device instead of an extension of a rigid construct, this might translate into a reduction in the development of yet another level of @entity1347 .

Posterior lumbar dynamic stabilization instead of arthrodesis for symptomatic adjacent-segment degenerative XXXX : description of a novel technique.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient', 'men'] @entity1643 :: ('MESH:D017116', 'Disease') :: ['low-back pain'] @entity1347 :: ('MESH:C537775', 'Disease') :: ['ASD', 'adjacent-segment disease'] @entity613 :: ('MESH:D007383', 'Disease') :: ['neurogenic claudication'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity6357 :: ('6164', 'Gene') :: ['L3-4'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis']
@entity850 :: (MESH:D003251,Disease) :: ['stenosis']
