NONFUSION STABILIZATION IN THE DEGENERATIVE LUMBAR SPINE DISEASES
Abstract
Background Modern style of living and the aging of the population increase the number of the patients with the degenerative diseases of the lumbar spine, especially in the active part of the population. Methods For the surgical treatment, different types of fusion were used in order to achieve the rigid stability of the affected motion segment. These techniques often lead to adjacent segments degeneration, therefore the development of the new dynamic systems, needing no fusion, occurred. With careful patient selection, the new operative techniques and instrumentation provide better results in these diseases. Results The results in the major centers, treating this pathology are encouraging, however being a new system, enough long-term results have to be available for proper evaluation of the method. In our department we treated 15 patients in one year, 11 of them were evaluated eight months after surgery with appropriate scales, so far with good results. Discussion Cosmic is a posterior nonfusion dynamic implant system, featuring hinged screws that provide a sufficient degree of dynamization and load sharing between the system and the vertebral column. The hinged screws are coated with bioactive calcium phosphate and connected adjacently with the rod, providing stability. The system provides a good rotational stability. The main indication for the Cosmic is symptomatic spinal stenosis accompanied by the spondylolisthesis. Conclusions Cosmic is a posterior dynamic nonfusion pedicle screw-rod system for the stabilization of the lumbar vertebral column. It represents the new step in the development of the spinal instrumentation and can efficiently replace the spondylodesis in the treatment of painful degenerative diseases of the lumbar spine.Downloads
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