Comparison of Long-Term Results of Dynamic and Rigid Systems at the Lumbar Level

INTRODUCTION: This study aimed to compare the safety, efficacy, radiological changes, and long-term results of transpedicular stabilization systems using a rigid rod with lumbar dynamics (PEEK) in terms of reoperation requirements.
METHODS: Patients who underwent two-level lumbar stabilization with 92 rigid systems and 54 dynamic systems between January 2017 and January 2020 were included in the study. The VAS and ODI scores, segmental and total lumbar lordosis angles, and upper and lower segment vertebral heights of the patients were evaluated. Preop, postop 1st day, postoperative 12th month, and postoperative 24th month values were compared.
RESULTS: Of the patients included in our study, 59 were male and 87 were female. The mean age was 58 years. Revision surgery was performed in 12 patients with a rigid system and 6 patients with a dynamic rod system. Preoperative VAS values were 8 (2-10) in the rigid group and 9 (6-10) in the dynamic group (p<0.05). At the 12th postoperative month, it was 4 (2-7) in the rigid group and 4 (2-6) in the dynamic group (p<0.05). Preoperative lumbar lordosis was 48.8 (29.6-80.8) in the rigid system, while it was 47.9 (11.5-83.7) in the dynamic system (p>0.05). At the 24th postoperative month, it was 46.5 (25.9-73.7) in the rigid group and 43.3 (20.2-79.6) in the dynamic group (p>0.05).
DISCUSSION AND CONCLUSION: Although the development time of adjacent segment disease is longer with PEEK rod dynamic systems compared to rigid rod systems, adjacent segment disease can be seen in both systems.