ObjectiveTo systematically review the effectiveness and safety of dynamic neutralization system (Dynesys) versus posterior lumbar interbody fusion (PLIF) for lumbar degenerative disease. MethodsDatabases including PubMed, EMbase, The Cochrane Library (Issue 5, 2016), CNKI, CBM, VIP and WanFang Data were searched to collect studies about Dynesys versus PLIF for lumbar degenerative disease from inception to May 31st 2016. Two reviewers independently screened literature, extracted data, and evaluated the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 22 studies involving 1 482 patients were included. The results of meta-analysis showed that, compared with PLIF, Dynesys could reduce operative time (MD=-29.62, 95%CI -36.67 to -22.57), operative blood loss (MD=-112.10, 95%CI -130.60 to -93.61), length of hospital stay (MD=-2.62, 95%CI -4.96 to -0.28), postoperative adjacent segment ROM (MD=-1.29, 95%CI -1.72 to -0.86) and maintain postoperative operated segment ROM (MD=3.53, 95%CI 1.99 to 5.08). There were no significant differences between two groups in postoperative ODI (MD=-1.51, 95%CI -3.58 to 0.55), postoperative back VAS (MD=-0.15, 95%CI -0.38 to 0.08), postoperative leg VAS (MD=-0.09, 95%CI -0.22 to 0.04) and postoperative complications (OR=0.69, 95%CI 0.45 to 1.06). ConclusionThe current evidence shows that compared with PLIF, Dynesys for lumbar degenerative disease has shorter operative time, less operative blood loss, shorter hospitalization days, and Dynesys can also maintain operated segment ROM and delay the degeneration of adjacent segment. Due to the limited quality of the included studies, more studies are needed to verify the above conclusion.
ObjectiveTo observe the efficacy and safety of the posterior fusion dynamic system (Dynesys) on lumbar intervertebral disc. MethodsBetween April 2010 and April 2012, 30 patients diagnosed lumbar disc herniation in our department were included in the study. The Dynesys was performed on these patients. Follow-up lasted for 6 to 12 months. We used visual analogue scale (VAS) and Oswestry disability index (ODI) to evaluate the efficacy and safety of the system at the time points of the day before surgery, 1 week, 3 months and 6 months after surgery. Paired-samples t-test was used in the data analysis. ResultsThe VAS score 1 day before surgery was 7.9±0.9; 1 week after surgery, VAS was 2.1±0.8 (t=49.395, P<0.001); 3 months after surgery, VAS was 1.6±0.4 (t=88.304, P<0.001); 6 months after surgery, VAS was 1.4±0.3 (t=93.721, P<0.001). ODI 1 day before surgery was (74.0±6.0)%; 1 week after surgery, ODI was (19.6±2.5)% (t=82.006, P<0.001); 3 months after surgery, ODI was (16.3±1.2)% (t=88.344, P<0.001); 6 months after surgery, ODI was (14.5±1.8)% (t=90.113, P<0.001). All the patients were given X ray review 1 week, 3 months, and 6 months after surgery. No screw loosening or breakage was detected. ConclusionThe combination of Dynesys and decompression surgery has been proved to be effective and safe in the short term. Dynesys reserves the mobility of pathological lumbar, ensures the stability of the posterior spine and corrects lumbar instability.