{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:07:52Z","timestamp":1779527272810,"version":"3.53.1"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Dynamic stabilization devices are designed to stabilize the spine while preserving some motion. However, there have been reports demonstrating limited motion at the instrumented level of the lumbar spine after Dynesys dynamic stabilization (DDS). The causes of this limited motion and its actual effects on outcomes after DDS remain elusive. In this study, the authors investigate the incidence of unintended facet arthrodesis after DDS and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective study included 80 consecutive patients with 1- or 2-level lumbar spinal stenosis who underwent laminectomy and DDS. All medical records, radiological data, and clinical evaluations were analyzed. Imaging studies included pre- and postoperative radiographs, MR images, and CT scans. Clinical outcomes were measured by a visual analog scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) scores. Furthermore, all patients had undergone postoperative CT for the detection of unintended arthrodesis of the facets at the indexed level, and range of motion was measured on standing dynamic radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 70 patients (87.5%) with a mean age of 64.0 years completed the minimum 24-month postoperative follow-up (mean duration 29.9 months). Unintended facet arthrodesis at the DDS instrumented level was demonstrated by CT in 38 (54.3%) of the 70 patients. The mean age of patients who had facet arthrodesis was 9.8 years greater than that of the patients who did not (68.3 vs 58.5 years, p = 0.009). There were no significant differences in clinical outcomes, including VAS back and leg pain, ODI, and JOA scores between patients with and without the unintended facet arthrodesis. Furthermore, those patients older than 60 years were more likely to have unintended facet arthrodesis (OR 12.42) and immobile spinal segments (OR 2.96) after DDS. Regardless of whether unintended facet arthrodesis was present or not, clinical evaluations demonstrated improvement in all patients (all p &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>During the follow-up of more than 2 years, unintended facet arthrodesis was demonstrated in 54.3% of the patients who underwent 1- or 2-level DDS. Older patients (age &gt; 60 years) were more likely to have unintended facet arthrodesis and subsequent immobile spinal segments. However, unintended facet arthrodesis did not affect the clinical outcomes during the study period. Further evaluations are needed to clarify the actual significance of this phenomenon.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.10.focus15404","type":"journal-article","created":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T03:36:37Z","timestamp":1451619397000},"page":"E4","source":"Crossref","is-referenced-by-count":25,"title":["Dynesys dynamic stabilization\u2013related facet arthrodesis"],"prefix":"10.3171","volume":"40","author":[{"given":"Li-Yu","family":"Fay","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"},{"name":"Institute of Pharmacology, National Yang-Ming University;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Yuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jau-Ching","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"},{"name":"Institute of Pharmacology, National Yang-Ming University;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Yun","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, National Taiwan University Hospital and College of Medicine, National Taiwan University;"},{"name":"Ophthalmology Department, Far Eastern Memorial Hospital, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Hsi","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan-Kan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Lan","family":"Wu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine and"},{"name":"Department of Radiology, Taipei Veterans General Hospital, Taipei; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrich","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"Faculty of Medicine, School of Medicine and"},{"name":"Institute of Pharmacology, National Yang-Ming University;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"1055","article-title":"Iliac crest bone graft harvest donor site morbidity. A statistical evaluation","volume":"20","author":"Banwart","year":"1995"},{"issue":"384","key":"b2-focus15404","series-title":"Clin Orthop Relat Res","first-page":"54","article-title":"Lumbar stenosis with spondylolisthesis: current concepts of surgical treatment","author":"Bassewitz","year":"2001"},{"key":"b3-focus15404","series-title":"J Spinal Disord Tech","first-page":"98","article-title":"Efficacy of translaminar facet screw fixation in circumferential interbody fusions as compared to pedicle screw fixation","volume":"19","author":"Best","year":"2006"},{"key":"b4-focus15404","series-title":"J Spinal Disord","first-page":"461","article-title":"The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis","volume":"6","author":"Bridwell","year":"1993"},{"key":"b5-focus15404","series-title":"Z Orthop Ihre Grenzgeb","first-page":"418","article-title":"[Posterior dynamic stabilization as an alternative for dorsoventral fusion in spinal stenosis with degenerative instability.]","volume":"141","author":"Cakir","year":"2003"},{"key":"b6-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"227","article-title":"Dynamic stabilization for degenerative lumbar scoliosis in elderly patients","volume":"35","author":"Di Silvestre","year":"2010"},{"key":"b7-focus15404","series-title":"Adv Orthop","first-page":"437570","article-title":"Intervertebral disc rehydration after lumbar dynamic stabilization: magnetic resonance image evaluation with a mean followup of four years","volume":"2013","author":"Fay","year":"2013"},{"key":"b8-focus15404","series-title":"Clin Neurol Neurosurg","first-page":"535","article-title":"Dynamic stabilization for degenerative spondylolisthesis: evaluation of radiographic and clinical outcomes","volume":"115","author":"Fay","year":"2013"},{"key":"b9-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"173","article-title":"The argument for instrumented decompressive posterolateral fusion for patients with degenerative spondylolisthesis and spinal stenosis","volume":"29","author":"Fischgrund","year":"2004"},{"key":"b10-focus15404","series-title":"Arch Orthop Trauma Surg","first-page":"127","article-title":"Dynamic neutralisation of the lumbar spine confirmed on a new lumbar spine simulator in vitro","volume":"119","author":"Freudiger","year":"1999"},{"key":"b11-focus15404","series-title":"Eur Spine J","first-page":"178","article-title":"Complications in lumbar fusion surgery for chronic low back pain: comparison of three surgical techniques used in a prospective randomized study. A report from the Swedish Lumbar Spine Study Group","volume":"12","author":"Fritzell","year":"2003"},{"key":"b12-focus15404","series-title":"Spine J","first-page":"13","article-title":"Lumbar fusion outcomes stratified by specific diagnostic indication","volume":"9","author":"Glassman","year":"2009"},{"key":"b13-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"324","article-title":"Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years","volume":"30","author":"Grob","year":"2005"},{"key":"b14-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"2775","article-title":"Preventive effect of artificial ligamentous stabilization on the upper adjacent segment impairment following posterior lumbar interbody fusion","volume":"34","author":"Imagama","year":"2009"},{"key":"b15-focus15404","series-title":"J Neurosurg Spine","first-page":"218","article-title":"Minimally invasive transforaminal lumbar interbody fusion with ipsilateral pedicle screw and contralateral facet screw fixation","volume":"3","author":"Jang","year":"2005"},{"issue":"6","key":"b16-focus15404","series-title":"Neurosurg Focus","first-page":"E10","article-title":"Screw loosening in the Dynesys stabilization system: radiographic evidence and effect on outcomes","volume":"28","author":"Ko","year":"2010"},{"key":"b17-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"2205","article-title":"Long adult spinal deformity fusion to the sacrum using rhBMP-2 versus autogenous iliac crest bone graft","volume":"34","author":"Maeda","year":"2009"},{"key":"b18-focus15404","series-title":"Spine J","first-page":"527","article-title":"Promoting fusion in minimally invasive lumbar interbody stabilization with low-dose bone morphogenic protein-2\u2014but what is the cost?","volume":"11","author":"Mannion","year":"2011"},{"key":"b19-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"E831","article-title":"Adjacent segment disease after posterior lumbar interbody fusion: based on cases with a minimum of 10 years of follow-up","volume":"40","author":"Nakashima","year":"2015"},{"issue":"16 Suppl","key":"b20-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"S68","article-title":"Dynamic stabilization in the surgical management of painful lumbar spinal disorders","volume":"30","author":"Nockels","year":"2005"},{"key":"b21-focus15404","series-title":"J Spinal Disord","first-page":"390","article-title":"The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis","volume":"5","author":"Panjabi","year":"1992"},{"key":"b22-focus15404","series-title":"Neurosurgery","first-page":"88","article-title":"Facet fusion in the lumbosacral spine: a 2-year follow-up study","volume":"51","author":"Park","year":"2002"},{"key":"b23-focus15404","series-title":"Z Orthop Ihre Grenzgeb","first-page":"166","article-title":"[Application of a dynamic pedicle screw system (DYNESYS) for lumbar segmental degenerations\u2014comparison of clinical and radiological results for different indications.]","volume":"142","author":"Putzier","year":"2004"},{"key":"b24-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"E109","article-title":"The surgical treatment of the lumbar disc prolapse: nucleotomy with additional transpedicular dynamic stabilization versus nucleotomy alone","volume":"30","author":"Putzier","year":"2005"},{"key":"b25-focus15404","series-title":"J Spinal Disord","first-page":"392","article-title":"Adjacent-segment degeneration after lumbar fusion with instrumentation: a retrospective study","volume":"9","author":"Rahm","year":"1996"},{"key":"b26-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"E636","article-title":"Minimum four-year follow-up of spinal stenosis with degenerative spondylolisthesis treated with decompression and dynamic stabilization","volume":"33","author":"Schaeren","year":"2008"},{"key":"b27-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"442","article-title":"Dynamic stabilization in addition to decompression for lumbar spinal stenosis with degenerative spondylolisthesis","volume":"31","author":"Schnake","year":"2006"},{"key":"b28-focus15404","series-title":"Orthop Clin North Am","first-page":"363","article-title":"Posterior dynamic stabilization systems: DYNESYS","volume":"36","author":"Schwarzenbach","year":"2005"},{"issue":"Suppl 2","key":"b29-focus15404","series-title":"Eur Spine J","first-page":"S170","article-title":"The dynamic neutralization system for the spine: a multi-center study of a novel non-fusion system","volume":"11","author":"Stoll","year":"2002"},{"issue":"24 Suppl","key":"b30-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"157S","article-title":"Internal fixation (pedicle screw fixation) for fusions of the lumbar spine","volume":"20","author":"Vaccaro","year":"1995"},{"key":"b31-focus15404","series-title":"J Bone Joint Surg Am","first-page":"1295","article-title":"Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. Four-year results in the Spine Patient Outcomes Research Trial (SPORT) randomized and observational cohorts","volume":"91","author":"Weinstein","year":"2009"},{"issue":"4","key":"b32-focus15404","series-title":"Neurosurg Focus","first-page":"E9","article-title":"Pedicle screw loosening in dynamic stabilization: incidence, risk, and outcome in 126 patients","volume":"31","author":"Wu","year":"2011"},{"key":"b1-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"1055","article-title":"Iliac crest bone graft harvest donor site morbidity. A statistical evaluation","volume":"20","author":"Banwart","year":"1995"},{"issue":"384","key":"b2-focus15404","series-title":"Clin Orthop Relat Res","first-page":"54","article-title":"Lumbar stenosis with spondylolisthesis: current concepts of surgical treatment","author":"Bassewitz","year":"2001"},{"key":"b3-focus15404","series-title":"J Spinal Disord Tech","first-page":"98","article-title":"Efficacy of translaminar facet screw fixation in circumferential interbody fusions as compared to pedicle screw fixation","volume":"19","author":"Best","year":"2006"},{"key":"b4-focus15404","series-title":"J Spinal Disord","first-page":"461","article-title":"The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis","volume":"6","author":"Bridwell","year":"1993"},{"key":"b5-focus15404","series-title":"Z Orthop Ihre Grenzgeb","first-page":"418","article-title":"[Posterior dynamic stabilization as an alternative for dorsoventral fusion in spinal stenosis with degenerative instability.]","volume":"141","author":"Cakir","year":"2003"},{"key":"b6-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"227","article-title":"Dynamic stabilization for degenerative lumbar scoliosis in elderly patients","volume":"35","author":"Di Silvestre","year":"2010"},{"key":"b7-focus15404","series-title":"Adv Orthop","first-page":"437570","article-title":"Intervertebral disc rehydration after lumbar dynamic stabilization: magnetic resonance image evaluation with a mean followup of four years","volume":"2013","author":"Fay","year":"2013"},{"key":"b8-focus15404","series-title":"Clin Neurol Neurosurg","first-page":"535","article-title":"Dynamic stabilization for degenerative spondylolisthesis: evaluation of radiographic and clinical outcomes","volume":"115","author":"Fay","year":"2013"},{"key":"b9-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"173","article-title":"The argument for instrumented decompressive posterolateral fusion for patients with degenerative spondylolisthesis and spinal stenosis","volume":"29","author":"Fischgrund","year":"2004"},{"key":"b10-focus15404","series-title":"Arch Orthop Trauma Surg","first-page":"127","article-title":"Dynamic neutralisation of the lumbar spine confirmed on a new lumbar spine simulator in vitro","volume":"119","author":"Freudiger","year":"1999"},{"key":"b11-focus15404","series-title":"Eur Spine J","first-page":"178","article-title":"Complications in lumbar fusion surgery for chronic low back pain: comparison of three surgical techniques used in a prospective randomized study. A report from the Swedish Lumbar Spine Study Group","volume":"12","author":"Fritzell","year":"2003"},{"key":"b12-focus15404","series-title":"Spine J","first-page":"13","article-title":"Lumbar fusion outcomes stratified by specific diagnostic indication","volume":"9","author":"Glassman","year":"2009"},{"key":"b13-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"324","article-title":"Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years","volume":"30","author":"Grob","year":"2005"},{"key":"b14-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"2775","article-title":"Preventive effect of artificial ligamentous stabilization on the upper adjacent segment impairment following posterior lumbar interbody fusion","volume":"34","author":"Imagama","year":"2009"},{"key":"b15-focus15404","series-title":"J Neurosurg Spine","first-page":"218","article-title":"Minimally invasive transforaminal lumbar interbody fusion with ipsilateral pedicle screw and contralateral facet screw fixation","volume":"3","author":"Jang","year":"2005"},{"issue":"6","key":"b16-focus15404","series-title":"Neurosurg Focus","first-page":"E10","article-title":"Screw loosening in the Dynesys stabilization system: radiographic evidence and effect on outcomes","volume":"28","author":"Ko","year":"2010"},{"key":"b17-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"2205","article-title":"Long adult spinal deformity fusion to the sacrum using rhBMP-2 versus autogenous iliac crest bone graft","volume":"34","author":"Maeda","year":"2009"},{"key":"b18-focus15404","series-title":"Spine J","first-page":"527","article-title":"Promoting fusion in minimally invasive lumbar interbody stabilization with low-dose bone morphogenic protein-2\u2014but what is the cost?","volume":"11","author":"Mannion","year":"2011"},{"key":"b19-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"E831","article-title":"Adjacent segment disease after posterior lumbar interbody fusion: based on cases with a minimum of 10 years of follow-up","volume":"40","author":"Nakashima","year":"2015"},{"issue":"16 Suppl","key":"b20-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"S68","article-title":"Dynamic stabilization in the surgical management of painful lumbar spinal disorders","volume":"30","author":"Nockels","year":"2005"},{"key":"b21-focus15404","series-title":"J Spinal Disord","first-page":"390","article-title":"The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis","volume":"5","author":"Panjabi","year":"1992"},{"key":"b22-focus15404","series-title":"Neurosurgery","first-page":"88","article-title":"Facet fusion in the lumbosacral spine: a 2-year follow-up study","volume":"51","author":"Park","year":"2002"},{"key":"b23-focus15404","series-title":"Z Orthop Ihre Grenzgeb","first-page":"166","article-title":"[Application of a dynamic pedicle screw system (DYNESYS) for lumbar segmental degenerations\u2014comparison of clinical and radiological results for different indications.]","volume":"142","author":"Putzier","year":"2004"},{"key":"b24-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"E109","article-title":"The surgical treatment of the lumbar disc prolapse: nucleotomy with additional transpedicular dynamic stabilization versus nucleotomy alone","volume":"30","author":"Putzier","year":"2005"},{"key":"b25-focus15404","series-title":"J Spinal Disord","first-page":"392","article-title":"Adjacent-segment degeneration after lumbar fusion with instrumentation: a retrospective study","volume":"9","author":"Rahm","year":"1996"},{"key":"b26-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"E636","article-title":"Minimum four-year follow-up of spinal stenosis with degenerative spondylolisthesis treated with decompression and dynamic stabilization","volume":"33","author":"Schaeren","year":"2008"},{"key":"b27-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"442","article-title":"Dynamic stabilization in addition to decompression for lumbar spinal stenosis with degenerative spondylolisthesis","volume":"31","author":"Schnake","year":"2006"},{"key":"b28-focus15404","series-title":"Orthop Clin North Am","first-page":"363","article-title":"Posterior dynamic stabilization systems: DYNESYS","volume":"36","author":"Schwarzenbach","year":"2005"},{"issue":"Suppl 2","key":"b29-focus15404","series-title":"Eur Spine J","first-page":"S170","article-title":"The dynamic neutralization system for the spine: a multi-center study of a novel non-fusion system","volume":"11","author":"Stoll","year":"2002"},{"issue":"24 Suppl","key":"b30-focus15404","series-title":"Spine (Phila Pa 1976)","first-page":"157S","article-title":"Internal fixation (pedicle screw fixation) for fusions of the lumbar spine","volume":"20","author":"Vaccaro","year":"1995"},{"key":"b31-focus15404","series-title":"J Bone Joint Surg Am","first-page":"1295","article-title":"Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. 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