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Posterior Dynamic Stabilization (Dynesys)
Spinal fusion is done to treat fractured (broken) vertebra; spinal deformity; elimination of pain from painful motion; treatment of instability; and treatment for disc herniations. A degenerative vertebral disc is commonly responsible for initiating symptoms and conditions treated by a spinal fusion. Spinal stenosis (compressed nerve) and spondylolisthesis (slipped disc) are among the top conditions caused by Degenerative Disc Disease. The intervertebral disc contains a gel like substance that lies between each vertebra for shock absorption and movement. With age, the disc can sometimes wear down much like a tire tread would on a car. Once the disc wears (degenerates), it can loose its ability to function correctly and generate pain even while performing normal actions like bending over and sitting (figure 1). A worn disc could eventually lead to a rupture (herniation) thereby causing the gel-like material inside the disc to discharge. As a result of a rupture, the disc material can press up against the spinal cord or sciatic nerve (spinal stenosis) causing pain, numbness or weakness in the leg, which is described as sciatica. Once the source of the damaged disc is found, surgeons may recommend a fusion or a solid union between two or more vertebrae (figure 3). Usually the damaged disc is removed entirely before a spinal fusion surgery takes place (discectomy). Once a fusion is complete a patient will have limited motion, which can alleviate pain by not allowing the same range of motion by the affected area. Another condition attributed to degenerative disc disease is referred to as spondylolisthesis or slipped disc. Sometimes the vertebral disc can deteriorate to the point where it begins to abnormally slip out of place (instability). Again, you could easily compare this condition to a tire loosing all of its tread. Once the vertebral disc slips out of place, it has the potential to press against nerves that run through the spine. Pain is normally felt right away in the lower back or leg. A spinal fusion may be recommended to keep the vertebrae stable without slipping. Surgeons may completely remove the damaged disc before the fusion surgery. Motion is inhibited in this case as well, limiting movement in the affected area. The Dynesys Spinal System is an alternative to a spinal fusion. The procedure uses flexible materials to stabilize the affected region of the spine while preserving a natural range of motion. External spacers surrounding a cord stabilize the joints thereby eliminating the pain caused by excess movement. The flexible implanted device permits, careful controlled movements in the effected joints. The treatment system has a clear advantage over fusion because of its ability to preserve some, if not all of the range of motion in the affected area. The Dynesys System augments fusion treatment by dynamically stabilizing the affected joints at rest, in flexion and in extension.Once the devices are attached bilaterally to the affected segments, the dynamic push-pull relationship between spacer and cord stabilizes the joints, keeping the vertebrae in a more natural position.
Frequently Asked QuestionsWhy the Dynesys System? The system provides an alternative to spinal fusion and additionally provides with several distinct benefits:
How long does the surgery take? A typical Dynesys surgery will take two to three hours. When can I go home after the surgery? Your release depends on how well you have adjusted to oral pain medications and if you can move around without complications. Is the pain relieved instantly after the surgery? Leg pain relief is felt immediately after the surgery, although it may take several weeks to recovery from the pain of the surgery. Which form of rehabilitation should I use? Physical therapy often follows surgery
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The Dynesys system is designed to stabilize the spine without fusing vertebrae, thereby allowing some natural motion. For a better understanding of why dynesys is indeed a major breakthrough in treating back pain, you should understand the concept of a spinal fusion or fixation.
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