A Review of Dynamic Stabilization in the Lumbar Spine

Lumbar spinal fusion is the gold standard for the treatment of degenerative instability of the lumbar spine; however, recently there has been increased concern over the sequelae of successful fusions. Pedicle screw-based dynamic stabilization was introduced as an alternative to fusions with the intent of decreasing morbidity and adjacent segment disease. Biomechanical studies have validated dynamic stabilization with Graf ligamentoplasty and the Dynesys system; however, at this time clinical results with these techniques are still unclear. Concerns exist with the quality of the existing studies and the absence of long-term follow-up. The use of polyaryletherketone (ie, PEEK) rods is an emerging technique with good biomechanical data, but currently there are no clinical studies. Greater-quality studies with long-term clinical and radiographic follow-up are needed before the role of pedicle screw-based dynamic stabilization in the treatment of degenerative lumbar instability can be determined.