Lumbar Stabilization with DSS-HPS() System: Radiological Outcomes and Correlation with Adjacent Segment Degeneration

October 26, 2021

. 2021 Oct 13;11(10):1891.

doi: 10.3390/diagnostics11101891.

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Andrea Angelini et al.

Diagnostics (Basel).

2021.

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Abstract

Arthrodesis has always been considered the main treatment of degenerative lumbar disease. Adjacent segment degeneration is one of the major topics related to fusion surgery. Non-fusion surgery may prevent this because of the protective effect of persisting segmental motion. The aims of the study were (1) to describe the radiological outcomes in the adjacent vertebral segment after lumbar stabilization with DSS-HPS^® system and (2) to verify the hypothesis that this system prevents the degeneration of the adjacent segment. This is a retrospective monocentric analysis of twenty-seven patients affected by degenerative lumbar disease underwent spinal hybrid stabilization with the DSS-HPS^® system between January 2016 and January 2019. All patients completed 1-year radiological follow-up. Preoperative X-rays and magnetic resonance images, as well as postoperative radiographs at 1, 6 and 12 months, were evaluated by one single observer. Pre- and post-operative anterior and posterior disc height at the dynamic (DL) and adjacent level (AL) were measured; segmental angle (SA) of the dynamized level were measured. There was a statistically significant decrease of both anterior (p = 0.0003 for the DL, p = 0.036 for the AL) and posterior disc height (p = 0.00000 for the DL, p = 0.00032 for the AL); there were a statistically significant variations of the segmental angle (p = 0.00000). Eleven cases (40.7%) of radiological progression of disc degeneration were found. The DSS-HPS^® system does not seem to reduce progression of lumbar disc degeneration in a radiologic evaluation, both in the dynamized and adjacent level.

Keywords:

DSS-HPS®; adjacent segment degeneration; dynamic stabilization; lumbar degeneration.

Conflict of interest statement

P.R. is consultant for Stryker and Exactech (not relevant with the present manuscript). The other authors declare that there are no relationships/conditions/circumstances that present a potential conflict of interest with the present manuscript.

Figures

**Figure 1**

Assessment of discal degeneration. (a) Preoperative and postoperative evaluation of the anterior discal heights (ADH) at the dynamized level (DL) and adjacent level (AL). (b) Preoperative and postoperative evaluation of the posterior discal heights (PDH) at the dynamized level (DL) and adjacent level (AL).

**Figure 2**

Preoperative and postoperative (6 months) radiological evaluation of the segmental angle (SA) between the dynamized level (DL) and adjacent level (AL).

References

1. Mashaly H., Paschel E.E., Khattar N., Goldschmidt E., Gerszten P.C. Posterior lumbar dynamic stabilization instead of arthrodesis for symptomatic adjacent-segment degenerative stenosis: Description of a novel technique. Neurosurg. Focus. 2016;40:E5. doi: 10.3171/2015.10.FOCUS15413.
  
  –
  
  DOI
  
  –
  
  PubMed
1. Cheh G., Bridwell K.H., Lenke L.G., Buchowski J., Daubs M.D., Kim Y., Baldus C. Adjacent Segment Disease Following Lumbar/Thoracolumbar Fusion with Pedicle Screw Instrumentation. Spine. 2007;32:2253–2257. doi: 10.1097/BRS.0b013e31814b2d8e.
  
  –
  
  DOI
  
  –
  
  PubMed
1. Chou W.-Y., Hsu C.-J., Chang W.-N., Wong C.-Y. Adjacent segment degeneration after lumbar spinal posterolateral fusion with instrumentation in elderly patients. Arch. Orthop. Trauma Surg. 2002;122:39–43. doi: 10.1007/s004020100314.
  
  –
  
  DOI
  
  –
  
  PubMed
1. Radcliff K.E., Kepler C.K., Jakoi A., Sidhu G.S., Rihn J., Vaccaro A.R., Albert T.J., Hilibrand A.S. Adjacent segment disease in the lumbar spine following different treatment interventions. Spine J. 2013;13:1339–1349. doi: 10.1016/j.spinee.2013.03.020.
  
  –
  
  DOI
  
  –
  
  PubMed
1. Greiner-Perth R., Sellhast N., Perler G., Dietrich D., Staub L.P., Röder C. Dynamic posterior stabilization for degenerative lumbar spine disease: A large consecutive case series with long-term follow-up by additional postal survey. Eur. Spine J. 2016;25:2563–2570. doi: 10.1007/s00586-016-4532-2.
  
  –
  
  DOI
  
  –
  
  PubMed