%0 Journal Article
%T Dynamic Stabilization for Challenging Lumbar Degenerative Diseases of the Spine: A Review of the Literature
%A Tuncay Kaner
%A Ali Fahir Ozer
%J Advances in Orthopedics
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/753470
%X Fusion and rigid instrumentation have been currently the mainstay for the surgical treatment of degenerative diseases of the spine over the last 4 decades. In all over the world the common experience was formed about fusion surgery. Satisfactory results of lumbar spinal fusion appeared completely incompatible and unfavorable within years. Rigid spinal implants along with fusion cause increased stresses of the adjacent segments and have some important disadvantages such as donor site morbidity including pain, wound problems, infections because of longer operating time, pseudarthrosis, and fatigue failure of implants. Alternative spinal implants were developed with time on unsatisfactory outcomes of rigid internal fixation along with fusion. Motion preservation devices which include both anterior and posterior dynamic stabilization are designed and used especially in the last two decades. This paper evaluates the dynamic stabilization of the lumbar spine and talks about chronologically some novel dynamic stabilization devices and thier efficacies. 1. Introduction Today, low back pain is one of the most important problem in decreasing the quality of life as a result of lumbar disc degeneration [1¨C4]. It is thought that the origin of low back pain results from degenerative intervertebral disc and facet joints. Segmental instability significantly contributed to lower back pain. Instability associated with intervertebral disc degeneration is represented first by Knutsson in 1944 [5]. Knutsson also described the abnormal flexion-extention slipping in X-ray along with disc degeneration and told that segmental instability should be if sagittal slipping is greater than 3£żmm in dynamic X-ray. Degeneration process of the lumbar spine and pathology of discogenic pain were described by Kirkaldy-Willis and Farfan in 1982 [2]. They explained that degenerative instability of the spine began primarily with disc degeneration which contains dehydration of intervertebral disc along with decrease in tension of the annulus fibrosis. It is followed by decrease of disc height, and then this process continues with hypertrophy of the facet joint and ligamentum flavum. At the end spinal stenosis and degenerative spondylolisthesis, which have caused low back pain, occur. Besides, Frymoyer and Selby revealed the concept of primary and secondary instabilities and put the degenerative disc disease, degenerative spondylolisthesis, and degenerative scoliotic deformities into the group of primary instability [6, 7]. Panjabi also well defined the term instability that leads to a pain,
%U http://www.hindawi.com/journals/aorth/2013/753470/