In This SectionTexas Health Research & Education Institute
Disease or Condition
Orthopedics / Spine
Study to compare Dynesys Spinal System to Silhouette Spinal Fixation System for spinal fusion (Orthopedics / Spine)
This study will compare patients that received the Dynesys Spinal System to those patients having the Silhouette Spinal Fixation System for spinal fusion.
Patients having degenerative spondylolisthesis or retrolisthesis (up to Grade I)
AND/OR Patients having lateral or central spinal stenosis or other stenosing lesion as diagnosed by radiculopathic signs, neurogenic claudication or imaging studies.
Candidate for single-level or contiguous two-level PLF between L1-S1.
Patients have a predominate component of leg rather than back symptoms; symptoms include pain, muscle weakness, and/or sensation abnormality as evidenced by patient history and diagnostic studies.
Patients may require decompression at the levels considered for treatment.
Pre-operative leg pain score > 40 mm on a 100 mm Visual Analog Scale (VAS)
Leg pain must be unresponsive to conservative (non-surgical) management for a minimum of 3 months.
Pre-operative Oswestry score > 30 indicating at least moderate disability.
Skeletally mature individual between ages 20 and 80.
Must be willing and able to comply with study requirements; including willing and able to sign a study-specific, IRB-approved informed consent form, complete necessary study paperwork and return for required follow-up visits.
Primary diagnosis of discogenic back pain at affected levels as evidenced by a larger back than leg pain component. In the event of multi-level pathology a discogram should be considered.
Patients with leg pain due to etiologies other than those listed above, such as trauma, peripheral vascular disease and neuropathy should be excluded.
Degenerative scoliosis >10° at the affected motion segment.
Supplemental interbody column support (e.g., bone graft, spacers or fusion cages) is planned at the affected level(s).
Greater than Grade I spondylolisthesis or retrolisthesis at the affected level(s).
Radiculopathic signs from more than two contiguous or two noncontiguous vertebral body segment(s).
Previous lumbar fusion attempt(s), previous total facetectomy or trauma at the affected level(s).
Gross obesity defined as exceeding ideal weight by greater than 40% (measurement details are given in Appendix A);
Active local or systemic infection.
Advanced osteoporosis as evidenced by plain film radiographs or history of fractures and confirmed by DEXA scan of < -2t for age group. All women over 50 and men over 60 should have a DEXA scan to confirm adequate bone density.
Receiving immunosuppressive or long-term steroid therapy.
Current chemical dependency or significant emotional and/or psychosocial disturbance that may impact treatment outcome or study participation as evidenced by three or more positive Waddell Signs.
evere muscular, neural or vascular diseases that endanger the spinal column.
Missing bone structures, due to severely deformed anatomy or congenital anomalies, which make good anchorage of the implant impossible;20. All concomitant diseases that can jeopardize the functioning and success of the patient.
Treatment of the thoracic and cervical spine.
Severely deformed anatomy due to congenital anomalies.