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Lumbar Dynamic Stabilization Surgery

What does “Lumbar Dynamic Stabilization” mean?

Here is the meaning of each word:

  1. Lumbar: area of the spine located in the low back
  2. Dynamic: a device which moves
  3. Stabilization: to provide stability to a segment of the spine

Altogether, “Lumbar Dynamic Stabilization” means placing a device on the back of the spine in the low back to stabilize it while still permitting some motion.

What is a Lumbar Dynamic Stabilization procedure?

A Lumbar Dynamic Stabilization procedure is a spine surgery where devices are inserted which allow for movement of the spine. Titanium screws are placed into the vertebrae from the back of the spine. However instead of connecting them with a solid titanium rod (fusion), they are connected with a motion device. This device will allow the spine segment to move but limits the motion.

Why is a Lumbar Dynamic Stabilization procedure done?

Lumbar Dynamic Stabilization is an alternative to a fusion surgery of the spine. Instead of trying to connect the vertebrae tightly together to prevent movement (fusion), the vertebrae are allowed to move a certain amount (dynamic stabilization). However the type of movement and the amount of it is controlled by the device. This provides stability for the spine. This surgery is often done for disc disease or facet joint disease of the low back.

Are Lumbar Dynamic Stabilization devices FDA approved?

The devices used for Lumbar Dynamic Stabilization are approved by the FDA for the use in fusion surgery, rather than to keep the spine moving. However, surgeons sometimes use it for purposes other than fusions. One example of a Lumbar Dynamic Stabilization device is the Dynesys System made by a spine company called Zimmer.

How is a Lumbar Dynamic Stabilization surgery done?

Here are some of the steps of the surgery:

  1. An intravenous catheter (IV) is placed and antibiotics given.
  2. The patient is taken to the Operating Room and placed on the back (supine).
  3. A General Anesthetic is given.
  4. The patient is carefully placed on the stomach (prone).
  5. The low back (lumbar spine) is cleaned with a sterile surgical solution and plastic sheets (drapes) are used around the site of the surgery.
  6. The correct spinal level is found with the help of an X-Ray machine.
  7. The surgeon makes a cut (incision) over the spine.
  8. The tissue under the skin is opened and pushed aside.
  9. The spinal muscles attachments to the vertebrae are separated from the bone and move to the side.
  10. The lamina and spinous process bones are seen.
  11. With the help of an X-Ray machine titanium screws are placed through the pedicle bone into the body of the vertebrae. This is done on each side of the vertebrae.
  12. The titanium screws are vertically connected to each other with the Lumbar Dynamic Stabilization device.
  13. The skin and tissue are closed.
  14. The patient is placed on the back (supine) and awoken from Anesthesia.
  15. The patient is brought to the Recovery Area.

How long does it take to complete a Lumbar Dynamic Stabilization surgery?

On average it can take 2-3 hours or more to complete this surgery for one level in the spine.

What is the recovery like from a Lumbar Dynamic Stabilization surgery?

Here are some of the steps of the recovery from this surgery:

  1. The patient is usually admitted to the hospital for at least an overnight stay, often 2-3 days.
  2. A low back brace may be used initially.
  3. A physical therapist may help with the initial recovery after surgery.
  4. After discharge from the hospital, specific instructions on activity are given. Lifting, bending, and twisting are often limited.
  5. The cuts (incisions) often take 4-6 weeks to heal depending on the type of Lumbar Fusion surgery.
  6. The surgeon will usually reevaluate the patient within several weeks. Often new X-Rays are taken at that time. These X-Rays may show the movement of the device in the spine.

What kind of benefit could patients gain from a Lumbar Dynamic Stabilization surgery?

This depends on the symptoms experienced before the surgery. The goal of the surgery is to allow the spine to move, but only to a certain degree. The hope is that this movement is now stable and predictable which could be less painful than before surgery.