e-ISSN: 2148-0842
Spinal ve Periferik Sinir Cerrahisi Bülteni
TND-SPSCG
Spinal ve Periferik Sinir Cerrahisi Bülteni

Spinal ve Periferik Sinir Cerrahisi Bülteni

2023, Sayı 100, No, 3     (Sayfalar: 032-036)

What are the Advantages and Disadvantages of Hybrid Stabilization?

Neşe Keser 1 ,Erhan Emel 1

1 SBÜ, Hamidiye Tıp Fakültesi, Bakırköy Prof.Dr.Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Eğitim ve Araştırma Hastanesi, Beyin ve Sinir Cerrahisi Kliniği, Türkiye

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Surgical interventions for degenerative spinal diseases include decompression and fusion surgery, widely utilized despite complications like instrumentation failure, adjacent segment degeneration (ASD), and pseudoarthrosis. The introduction of fusion-free (dynamic stabilization) aimed to address these issues, but studies suggest limited advantages, with revision surgery rates reaching 34%. Consequently, hybrid stabilization, combining rigid fusion and dynamic elements, emerged to mitigate stress concentration and prevent accelerated degeneration in adjacent segments. The Dynesys-Transition-Optima (DTO) hybrid device by Zimmer Spine, comprising dynamic (flexible without fusion) and static (rigid with fusion) components, was developed for this purpose. Additionally, interspinous device-based hybrid stabilization is employed. Clinical outcomes indicate DTO as a safe and effective alternative for unstable lumbar spine diseases (satisfaction rate: 60%-90%), yet postoperative complications, including adjacent segment diseases (ASDi), screw loosening, and breakage, have been reported. Long-term follow-ups reveal lower ASD rates with the hybrid system than with the dynamic system. However, safety concerns persist for dynamic hybrid devices, warranting further biomechanical studies and clinical research to enhance implant flexibility, optimize design, and ensure patient safety.

Anahtar Kelimeler : Advantages and disadvantages, Hybrid stabilization, Surgical treatment, Symptomatic degenerative diseases of the spine, Vertebra