Dynamic spine stabilization without screws



Dynamic spinal stabilization is one of the options for improving function and reducing the mechanical impact of circumferential arthrodesis (interbody disc and pedicle screws). This system uses a cage or interbody disc to replace and maintain proper fixation of the vertebral bodies by removing the damaged vertebral disc, and the placement of an interspinous spacer secured with a Dacron ligament from the adjacent vertebrae.

The procedure is performed via a posterior approach and offers shorter surgical time and less intraoperative bleeding, lasting an hour and a half. Candidate patients do not present vertebral segment instability with anterolisthesis or retrolisthesis, although in mild cases, the surgeon may consider it, as he or she is the only one who can recommend surgical treatment after assessing the patient's clinical picture and appropriate imaging tests. Spinal surgery is performed via a posterior approach (through the back) under general anesthesia. The damaged disc is removed, located both before and during the procedure with a fluoroscope. The nerve roots are then protected from damage and an interbody cage is placed to open the foramans that were closed or had lost height. A spacer is then placed between the interspinous space. These come in different sizes, and the surgeon must select them correctly to avoid imbalances. Finally, the ligament integrated into the spacer allows for proper fixation of the vertebral segment. The advantages of this procedure include easier muscle regeneration and proper integration with the Dacron ligament, as well as avoiding the degenerative effects of the adjacent discs that patients may experience in the long term. Upon completion of spinal surgery, the patient is able to stand up the same day wearing a lumbar support belt with posterior reinforcement. Radiological follow-ups will be required in the following weeks to assess the consolidation of the interbody cage, which usually occurs 2-3 months after the procedure. Clinical follow-up with a multidisciplinary team consisting of a physician, a spine surgeon, and a physical therapist is always recommended to individualize each patient's progress and goals during the postoperative period.