The adverse events in lumbar dynamic stabilization: a prospective case series

BACKGROUND: We aimed to evaluate the complication rate in lumbar dynamic stabilization surgery for back pain in situations where conventional rigid implants could have been employed, with a follow-up of at least five years. METHODS AND FINDINGS: All patients who underwent semi-rigid lumbar spine fixation with the dynamic system consecutively between 2002 and 2007 in our departmentwere included. Minimum follow up period was 5. Adverse events and reoperations were registered for analysis. In the study period, 144 patients were treated with the dynamic system and studied. Three screws were badly positioned. There were two (1,39%) infections, with surgical cleaning necessary in one case. The late complications included a radiolucency signal in 22 screws (2,86%) and four broken screws (0,52%) out of 770 screws.Nineteen patients (20,13%) needed reoperation due to pain or screw associated problems. Three (2,08%) of these cases received additional treatment due to segmental kyphosis, five (3,47%) due to flat back, five (3,47%) due to adjacent level stenosis, 4 (2,7%) due to lumbar pain complaints, and two (1,39%) due to a broken screw. CONCLUSIONS: The lumbar dynamic stabilization system is an option for the treatment of degenerative spinal diseases. However it is not free of adverse events and had rates of implant failure, complications, and reoperations similar to those described on literature with rigid systems.