Complications of 2-Level Dynamic Stabilization: A Correlative Clinical and Radiological Analysis at Two-Year Follow-up on 103 Patients

Özet

AIM: To investigate the postoperative complications, such as screw loosening, screw breakage and adjacent segment disease(ASD), in patients who underwent surgery with 2-level dynamic stabilization systems.MATERIAL and METHODS: Postoperative complications, clinical improvements and radiological parameters in patients whounderwent surgery using a dynamic system for 2-level lumbar stabilization were retrospectively reviewed. A total of 103 patientswith lumbar degenerative spinal instability underwent 2-level dynamic stabilization. Clinical findings were reviewed at 2-year followup. Screw breakage and loosening were evaluated during this duration together with clinical findings.RESULTS: Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores were significantly decreased at the four-monthevaluation, and they were also decreased at the 1-year follow up and at the 24th postoperative month. ASD 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 screwloosening cases. The complication rate of 2-level dynamic stabilization was high in this study.CONCLUSION: Our results showed that complications (screw loosening or breakage and adjacent segment disease) are notrare after 2-level dynamic stabilization, unlike the acceptable results with the single-level dynamic system. The most probableexplanation is that the instrument system behaves more rigidly with every additional segment.