Dynamic spinal stabilization without screws



Dynamic stabilization of the spine is one of the alternatives to improve function and reduce the mechanical impacts of circumferential atrodesis (interbody disc and pedicle screws). This system is performed with an intersomatic box or disc to supply and maintain a correct fixation of the vertebral bodies by removing the damaged vertebral disc, and a placement of an interspinous spacer fixed with Dacron ligament of the adjacent vertebrae.

The procedure is performed posteriorly and presents less surgical time and less intraoperative bleeding, lasting an hour and a half. Candidate patients do not present instability of the vertebral segments with anterolisthesis or retrolisthesis, although in mild cases it may be considered by the surgeon, since he is the only one who can recommend surgical treatment, once assessing the clinical picture of the patients and the tests correct image. Posterior spine surgery (through the back) and under general anesthesia. The damaged disc is removed, previously located and during the procedure with a fluoroscope, then protecting the nerve roots so as not to damage them and placing an interbody cage that will allow opening the forámanes that were closed or with loss of height. After placing a Spacer between the interspinous space. These are of different sizes and that the surgeon, to avoid balance decompensations, must select correctly. Finally, the ligament that is integrated into the spacer, allowing the vertebral segment to be correctly fixed. The advantages of this procedure are that the muscles regenerate easier and it can be correctly integrated into the Dacron ligament, as well as avoiding the degenerative effect of the adjacent discs that patients may have in the long term. At the end of the spine surgery, the patient is able to stand up the same day with a lumbar girdle with posterior reinforcement, and will require radiological controls in the following weeks to assess the consolidation of the intersomatic cage, which usually takes 2-3 months after the intervention. Clinical follow-up with a multidisciplinary team consisting of a doctor, a surgeon specialized in the spine and a physiotherapist is always recommended, to individualize the progress and goals of each patient during the postoperative period.