Risk factors for screw loosening in patients with lumbar degenerative spondylolisthesis treated with Dynesys dynamic stabilization.

Yen-Chun Huang, Hsi-Hsien Lin, Shih-Tien Wang, Po-Hsin Chou, Chien-Lin Liu, Yu-Cheng Yao
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Abstract

Background: Posterior decompression with Dynesys dynamic stabilization (DDS) is an effective treatment option for degenerative spondylolisthesis. However, postoperative pedicle screw loosening (PSL) often results in poor outcomes. Determining possible risk factors may aid in making informed decisions. This study aimed to evaluate the incidence and risk factors for PSL in patients who underwent elective DDS.

Methods: We conducted a retrospective analysis of 94 patients with L4-L5 grade I degenerative spondylolisthesis who underwent DSS at a single academic institution between May 2008 and February 2015. Screw loosening was defined as a halo or double halo sign on plain radiography.

Results: The screw loosening rate was 4.8% among screws and 11.7% among patients. Multivariate analysis revealed that age >65 years, smoking, segmental ROM >13°, and L1 vertebral body (VB) Hounsfield unit (HU) <110 were risk factors for PSL after DDS. Five reoperations were performed; however, no screw breakage was observed. The Oswestry Disability Index and visual analog scale scores did not differ significantly at the final follow-up between the screw loosening and no screw loosening groups.

Conclusion: Our study suggests that patients with age >65 years, smoking, segmental ROM >13°, and L1 VB HU <110 had a higher risk of PSL after DDS.

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采用Dynesys动态稳定技术治疗腰椎退行性滑脱症患者的螺钉松动风险因素。
背景:使用Dynesys动态稳定(DDS)进行后路减压是治疗退行性脊椎滑脱症的有效方法。然而,术后椎弓根螺钉松动(PSL)往往会导致不良后果。确定可能的风险因素有助于做出明智的决定。本研究旨在评估选择性 DDS 患者 PSL 的发生率和风险因素:我们对2008年5月至2015年2月期间在一家学术机构接受DSS手术的94名L4-L5 I级退行性脊椎滑脱症患者进行了回顾性分析。螺钉松动的定义是平片上出现光环或双光环征象:螺钉松动率为4.8%,患者为11.7%。多变量分析显示,年龄大于65岁、吸烟、节段ROM大于13°和L1椎体(VB)Hounsfield单位(HU)结论:我们的研究表明,年龄大于 65 岁、吸烟、节段 ROM >13° 和 L1 椎体 HU
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