Dynamic Stabilization with Polyetheretherketone (PEEK) Rods: Mid-term Results (5 Years) in Lumbar Spine Degenerative Diseases in a Comprehensive Patients Series-Radiological and Clinical Assessment
Presented at SMISS Annual Forum 2018
By Ahmet Öğrenci MD
Disclosures: Ahmet Öğrenci MD None
The most important problems in the patients that treated with rigid systems are the adjacent segment disease and pseudoarthrosis. Rigid stabilization decreases the range of motion of the spinal column and causes the increased stress in the adjacent levels in the postoperative period. Dynamic instrumentation is less invasive and advantageous in many ways as it provides stabilization as well as balances stress on the adjacent segment and decreases pseudoarthrosis. In the majority of degenerative spinal diseases, the use of dynamic rod (PEEK) can solve many problems in short and long term with tolerable. A bit support for the existing segmental instability is sufficient if there is no obvious, evident instability. There is no study to assess the mid-term results of PEEK rod use in degenerative spine diseases.
The aim of this study is to evaluate the satisfaction of patients operated due to degenerative lumbar spinal diseases with Polyetheretherketone (PEEK) rod dynamic stabilization and to share their clinical and radiological results (mid-term) with Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores.
Retrospective clinical and radiological study. The preoperative and postoperative (final follow up with a minimum 2 years) low back pain, leg pain VAS and ODI values of 206 patients were evaluated whom operated for degenerative spine diseases. Preoperative- postoperative lumbar lordosis were compared. The patients included to the study were evaluated postoperatively around the 2nd year with lumbar MRI by means of adjacent segment disease and additional problems. Patients were grouped and compared in many directions.
Although radiological evaluations of patients showed significant statistically difference between the preoperative and postoperative periods in the lumbar lordosis, a clinically significant increase in lordosis angle was not achieved. Significant improvement was observed in the comparison of preoperative postoperative period in the analysis of patients' preoperative low back pain (p<0.0001) and decompression-related leg pain VAS scores. (p<0.0001) Significant improvement was also observed in the ODI scores of the patients. (p<0.0001) Of 206 patients with dynamic stabilization, there were 8 patients who underwent reoperation. (%3.8)
Although it is statistically significant, it can be seen that the lumbar lordosis cannot be corrected at very high degrees radiographically in the operations performed with the PEEK rod. Dynamic stabilization with PEEK rod is insufficient in the sagittal malalignment correction, but the mid-term results reached satisfactory reoperations rates, clinically outcomes. Rate of adjacent segment disease is quite low in stabilization with PEEK rod.