Dynamic compared to rigid fixation in lumbar spine: a
               systematic review

Botelho, Ricardo Vieira; Bastianello Junior, Rafael; Albuquerque, Luciana DiniGianini de; Bernardo, Wanderley Marques

doi:10.1590/1806-9282.60.02.013

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Revista da Associação Médica Brasileira

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Sumário

REVIEW ARTICLES • Rev. Assoc. Med. Bras. 60 (2) • 2014 • https://doi.org/10.1590/1806-9282.60.02.013 copy

Dynamic compared to rigid fixation in lumbar spine: a systematic review

Fixação pedicular dinâmica comparada com a fixação rígida na coluna lombar: uma revisão sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

The objective of this review is to reveal the quality of published data and the effect size of DPFs compared to rigid fixation in lumbar spine. Summary of background data: since 2002, several dynamic pedicle fixation (DPF) systems have been developed with the aim to stabilize the spine without the undesirable effects of rigid lumbar spine fixation. Nearly ten years later, there are several studies on these dynamic systems.

Methods:

A systematic review was done in MEDLINE/PubMED, Embase, Cochrane Central Register of Randomized Trials and Google Scholar to assess the quality of published literature and the available studied outcomes in randomized controlled trials of DPF.

Results:

Only three papers described randomized trials studying DPF. One of them focused on protection of adjacent level disease provided by DPF.

Conclusion:

It was not possible to reveal any evidence for benefits using DPF compared to rigid fixation in surgery for lumbar spine.

lumbar vertebrae; intervertebral disc degeneration; surgical fixation devices; internal fixators; bone screws; spinal fusion

Author/Year	Korovesis et al. 2002	Korovesis et al. 2004	Putzier et al. 2010
Domain
Selection bias
Random sequence generation.	No	No	Randlist Software (DataInf GmbH, Tübingen, Germany).
Allocation concealment.	No	No	No
Performance bias
Blinding of participants and personnel Assessments should be made for each main outcome (or class of outcomes).	No	Radiological criteria were analyzed by independent evaluators.	The blinded radiographs were evaluated independently by both a radiologist specializing in spinal imaging and an orthopedic surgeon. A second independent orthopedic surgeon was consulted to adjudicate conflicting fusion findings.
Detection bias
Blinding of outcome assessment Assessments should be made for each main outcome (or class of outcomes).	No	Radiological criteria were analyzed by independent evaluators.	The blinded radiographs were evaluated independently by both a radiologist specializing in spinal imaging and an orthopedic surgeon. A second independent orthopedic surgeon was consulted to adjudicate conflicting fusion findings.
Attrition bias
Incomplete outcome data Assessments should be made for each main outcome (or class of outcomes).	No (only three months of FU).	There were no follow-up losses.	The mean long-term follow-up was 76.4 months (60-91 months). Five patients (5/30) from the SLF group and eight patients (8/30) from the DFT group failed to attend every follow-up and were therefore excluded.
Reporting bias
Selective reporting.	Only radiographic findings were studied.	No

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[1] Correspondence: Address: Rua Tuim 585, (122A), Moema, São Paulo, SP - Brazil, ZIP Code: 04514-102. bitbot@uol.com.br