{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:07:23Z","timestamp":1779527243452,"version":"3.53.1"},"reference-count":66,"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":"\n OBJECTIVE<\/jats:title>\n In the past decade, dynamic stabilization has been an emerging option of surgical treatment for lumbar spondylosis. However, the application of this dynamic construct for mild spondylolisthesis and its clinical outcomes remain uncertain. This study aimed to compare the outcomes of Dynesys dynamic stabilization (DDS) with minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for the management of single-level spondylolisthesis at L4\u20135.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n This study retrospectively reviewed 91 consecutive patients with Meyerding Grade I spondylolisthesis at L4\u20135 who were managed with surgery. Patients were divided into 2 groups: DDS and MI-TLIF. The DDS group was composed of patients who underwent standard laminectomy and the DDS system. The MI-TLIF group was composed of patients who underwent MI-TLIF. Clinical outcomes were evaluated by visual analog scale for back and leg pain, Oswestry Disability Index, and Japanese Orthopaedic Association scores at each time point of evaluation. Evaluations included radiographs and CT scans for every patient for 2 years after surgery.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 86 patients with L4\u20135 spondylolisthesis completed the follow-up of more than 2 years and were included in the analysis (follow-up rate of 94.5%). There were 64 patients in the DDS group and 22 patients in the MI-TLIF group, and the overall mean follow-up was 32.7 months. Between the 2 groups, there were no differences in demographic data (e.g., age, sex, and body mass index) or preoperative clinical evaluations (e.g., visual analog scale back and leg pain, Oswestry Disability Index, and Japanese Orthopaedic Association scores). The mean estimated blood loss of the MI-TLIF group was lower, whereas the operation time was longer compared with the DDS group (both p < 0.001). For both groups, clinical outcomes were significantly improved at 6, 12, 18, and 24 months after surgery compared with preoperative clinical status. Moreover, there were no differences between the 2 groups in clinical outcomes at each evaluation time point. Radiological evaluations were also similar and the complication rates were equally low in both groups.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n At 32.7 months postoperation, the clinical and radiological outcomes of DDS were similar to those of MI-TLIF for Grade I degenerative spondylolisthesis at L4\u20135. DDS might be an alternative to standard arthrodesis in mild lumbar spondylolisthesis. However, unlike fusion, dynamic implants have issues of wearing and loosening in the long term. Thus, the comparable results between the 2 groups in this study require longer follow-up to corroborate.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2015.10.focus15441","type":"journal-article","created":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T03:36:37Z","timestamp":1451619397000},"page":"E3","source":"Crossref","is-referenced-by-count":33,"title":["Dynamic stabilization for L4\u20135 spondylolisthesis: comparison with minimally invasive transforaminal lumbar interbody fusion with more than 2 years of follow-up"],"prefix":"10.3171","volume":"40","author":[{"given":"Chao-Hung","family":"Kuo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Yuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"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":"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":"School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Yu","family":"Fay","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine and"},{"name":"Institute of Pharmacology, National Yang-Ming University; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Hsi","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine and"},{"name":"Molecular Medicine Program, Taiwan International Graduate Program, Academia Sinica, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrich","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine and"},{"name":"Institute of Pharmacology, National Yang-Ming University; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital;"},{"name":"School of Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15441","series-title":"Eur Spine J","first-page":"1486","article-title":"Interobserver reliability of detecting Dynesys pedicle screw using plain X-rays: a study on 50 post-operative patients","volume":"18","author":"Dakhil-Jerew","year":"2009"},{"key":"b2-focus15441","series-title":"J Neurosurg Spine","first-page":"560","article-title":"Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up","volume":"9","author":"Dhall","year":"2008"},{"key":"b3-focus15441","series-title":"Spine J","first-page":"1","article-title":"Degenerative lumbar scoliosis in elderly patients: dynamic stabilization without fusion versus posterior instrumented fusion","volume":"14","author":"Di Silvestre","year":"2014"},{"key":"b4-focus15441","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":"b5-focus15441","series-title":"J Am Acad Orthop Surg","first-page":"203","article-title":"Surgical management of lumbar degenerative spondylolisthesis","volume":"22","author":"Eismont","year":"2014"},{"key":"b6-focus15441","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":"b7-focus15441","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":"b8-focus15441","series-title":"J Spinal Disord Tech","first-page":"236","article-title":"Radiostereometric analysis of postoperative motion after application of Dynesys dynamic posterior stabilization system for treatment of degenerative spondylolisthesis","volume":"23","author":"Fayyazi","year":"2010"},{"key":"b9-focus15441","series-title":"Z Orthop Ihre Grenzgeb","first-page":"343","article-title":"[A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author's transl).]","volume":"120","author":"Harms","year":"1982"},{"key":"b10-focus15441","series-title":"J Spinal Disord Tech","article-title":"Long-term outcome after monosegmental l4\/5 stabilization for degenerative spondylolisthesis with the Dynesys device","author":"Hoppe","year":"2012"},{"key":"b11-focus15441","series-title":"Indian J Orthop","first-page":"562","article-title":"Minimally invasive transforaminal lumbar interbody fusion: Results of 23 consecutive cases","volume":"48","author":"Jhala","year":"2014"},{"key":"b12-focus15441","series-title":"World Neurosurg","first-page":"65","article-title":"Evidence-based review of transforaminal lumbar interbody fusion: is minimally invasive better?","volume":"82","author":"Kaloostian","year":"2014"},{"issue":"6","key":"b13-focus15441","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":"b14-focus15441","series-title":"Eur Spine J","first-page":"815","article-title":"Treatment of degenerative spondylolisthesis: potential impact of dynamic stabilization based on imaging analysis","volume":"18","author":"Lawhorne","year":"2009"},{"key":"b15-focus15441","series-title":"J Neurosurg Spine","first-page":"585","article-title":"Decompression and nonfusion dynamic stabilization for spinal stenosis with degenerative lumbar scoliosis: Clinical article","volume":"21","author":"Lee","year":"2014"},{"key":"b16-focus15441","series-title":"J Neurosurg Spine","first-page":"771","article-title":"Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior\/transforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients","volume":"14","author":"McGirt","year":"2011"},{"key":"b17-focus15441","series-title":"Spine (Phila Pa 1976)","first-page":"1938","article-title":"Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature","volume":"29","author":"Park","year":"2004"},{"key":"b18-focus15441","series-title":"Minim Invasive Neurosurg","first-page":"33","article-title":"Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis","volume":"54","author":"Parker","year":"2011"},{"key":"b19-focus15441","series-title":"World Neurosurg","first-page":"230","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and costutility analysis","volume":"82","author":"Parker","year":"2014"},{"key":"b20-focus15441","series-title":"Acta Neurochir (Wien)","first-page":"221","article-title":"Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis","volume":"156","author":"Payer","year":"2014"},{"key":"b21-focus15441","series-title":"J Bone Joint Surg Br","first-page":"457","article-title":"The significance of radiolucent zones surrounding pedicle screws. Definition of screw loosening in spinal instrumentation","volume":"86","author":"Sand\u00e9n","year":"2004"},{"key":"b22-focus15441","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":"b23-focus15441","series-title":"Int Orthop","first-page":"1683","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience","volume":"33","author":"Schizas","year":"2009"},{"key":"b24-focus15441","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":"b25-focus15441","series-title":"Rev Esp Cir Ortop Traumatol","first-page":"85","article-title":"[Pedicular dynamic stabilization system. Functional outcomes and implant-related complications for the treatment of degenerative lumbar disc disease with a minimum follow-up of 4 years.]","volume":"58","author":"Segura-Trepichio","year":"2014"},{"issue":"6 Suppl","key":"b26-focus15441","series-title":"Spine (Phila Pa 1976)","first-page":"S71","article-title":"Degenerative spondylolisthesis: review of current trends and controversies","volume":"30","author":"Sengupta","year":"2005"},{"key":"b27-focus15441","series-title":"Ochsner J","first-page":"32","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis grades 1\u20132: patient-reported clinical outcomes and cost-utility analysis","volume":"14","author":"Sulaiman","year":"2014"},{"key":"b28-focus15441","series-title":"Spine J","first-page":"2078","article-title":"Perioperative complications related to minimally invasive transforaminal lumbar fusion: evaluation of 204 operations on lumbar instability at single center","volume":"14","author":"Wang","year":"2014"},{"key":"b29-focus15441","series-title":"N Engl J Med","first-page":"2257","article-title":"Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis","volume":"356","author":"Weinstein","year":"2007"},{"key":"b30-focus15441","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":"1","key":"b31-focus15441","series-title":"Neurosurg Focus","first-page":"E8","article-title":"Clinical outcomes of the Dynesys dynamic neutralization system: 1-year preliminary results","volume":"22","author":"Welch","year":"2007"},{"issue":"4","key":"b32-focus15441","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":"b33-focus15441","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"131","article-title":"Transforaminal lumbar interbody fusion: comparison between open and mini-open approaches with two years follow-up","volume":"74","author":"Zairi","year":"2013"},{"key":"b1-focus15441","series-title":"Eur Spine J","first-page":"1486","article-title":"Interobserver reliability of detecting Dynesys pedicle screw using plain X-rays: a study on 50 post-operative patients","volume":"18","author":"Dakhil-Jerew","year":"2009"},{"key":"b2-focus15441","series-title":"J Neurosurg Spine","first-page":"560","article-title":"Clinical and radiographic comparison of mini-open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up","volume":"9","author":"Dhall","year":"2008"},{"key":"b3-focus15441","series-title":"Spine J","first-page":"1","article-title":"Degenerative lumbar scoliosis in elderly patients: dynamic stabilization without fusion versus posterior instrumented fusion","volume":"14","author":"Di Silvestre","year":"2014"},{"key":"b4-focus15441","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":"b5-focus15441","series-title":"J Am Acad Orthop Surg","first-page":"203","article-title":"Surgical management of lumbar degenerative spondylolisthesis","volume":"22","author":"Eismont","year":"2014"},{"key":"b6-focus15441","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":"b7-focus15441","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":"b8-focus15441","series-title":"J Spinal Disord Tech","first-page":"236","article-title":"Radiostereometric analysis of postoperative motion after application of Dynesys dynamic posterior stabilization system for treatment of degenerative spondylolisthesis","volume":"23","author":"Fayyazi","year":"2010"},{"key":"b9-focus15441","series-title":"Z Orthop Ihre Grenzgeb","first-page":"343","article-title":"[A one-stager procedure in operative treatment of spondylolistheses: dorsal traction-reposition and anterior fusion (author's transl).]","volume":"120","author":"Harms","year":"1982"},{"key":"b10-focus15441","series-title":"J Spinal Disord Tech","article-title":"Long-term outcome after monosegmental l4\/5 stabilization for degenerative spondylolisthesis with the Dynesys device","author":"Hoppe","year":"2012"},{"key":"b11-focus15441","series-title":"Indian J Orthop","first-page":"562","article-title":"Minimally invasive transforaminal lumbar interbody fusion: Results of 23 consecutive cases","volume":"48","author":"Jhala","year":"2014"},{"key":"b12-focus15441","series-title":"World Neurosurg","first-page":"65","article-title":"Evidence-based review of transforaminal lumbar interbody fusion: is minimally invasive better?","volume":"82","author":"Kaloostian","year":"2014"},{"issue":"6","key":"b13-focus15441","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":"b14-focus15441","series-title":"Eur Spine J","first-page":"815","article-title":"Treatment of degenerative spondylolisthesis: potential impact of dynamic stabilization based on imaging analysis","volume":"18","author":"Lawhorne","year":"2009"},{"key":"b15-focus15441","series-title":"J Neurosurg Spine","first-page":"585","article-title":"Decompression and nonfusion dynamic stabilization for spinal stenosis with degenerative lumbar scoliosis: Clinical article","volume":"21","author":"Lee","year":"2014"},{"key":"b16-focus15441","series-title":"J Neurosurg Spine","first-page":"771","article-title":"Comparative analysis of perioperative surgical site infection after minimally invasive versus open posterior\/transforaminal lumbar interbody fusion: analysis of hospital billing and discharge data from 5170 patients","volume":"14","author":"McGirt","year":"2011"},{"key":"b17-focus15441","series-title":"Spine (Phila Pa 1976)","first-page":"1938","article-title":"Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature","volume":"29","author":"Park","year":"2004"},{"key":"b18-focus15441","series-title":"Minim Invasive Neurosurg","first-page":"33","article-title":"Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis","volume":"54","author":"Parker","year":"2011"},{"key":"b19-focus15441","series-title":"World Neurosurg","first-page":"230","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and costutility analysis","volume":"82","author":"Parker","year":"2014"},{"key":"b20-focus15441","series-title":"Acta Neurochir (Wien)","first-page":"221","article-title":"Dynamic transpedicular stabilisation and decompression in single-level degenerative anterolisthesis and stenosis","volume":"156","author":"Payer","year":"2014"},{"key":"b21-focus15441","series-title":"J Bone Joint Surg Br","first-page":"457","article-title":"The significance of radiolucent zones surrounding pedicle screws. Definition of screw loosening in spinal instrumentation","volume":"86","author":"Sand\u00e9n","year":"2004"},{"key":"b22-focus15441","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":"b23-focus15441","series-title":"Int Orthop","first-page":"1683","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion: evaluating initial experience","volume":"33","author":"Schizas","year":"2009"},{"key":"b24-focus15441","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":"b25-focus15441","series-title":"Rev Esp Cir Ortop Traumatol","first-page":"85","article-title":"[Pedicular dynamic stabilization system. Functional outcomes and implant-related complications for the treatment of degenerative lumbar disc disease with a minimum follow-up of 4 years.]","volume":"58","author":"Segura-Trepichio","year":"2014"},{"issue":"6 Suppl","key":"b26-focus15441","series-title":"Spine (Phila Pa 1976)","first-page":"S71","article-title":"Degenerative spondylolisthesis: review of current trends and controversies","volume":"30","author":"Sengupta","year":"2005"},{"key":"b27-focus15441","series-title":"Ochsner J","first-page":"32","article-title":"Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis grades 1\u20132: patient-reported clinical outcomes and cost-utility analysis","volume":"14","author":"Sulaiman","year":"2014"},{"key":"b28-focus15441","series-title":"Spine J","first-page":"2078","article-title":"Perioperative complications related to minimally invasive transforaminal lumbar fusion: evaluation of 204 operations on lumbar instability at single center","volume":"14","author":"Wang","year":"2014"},{"key":"b29-focus15441","series-title":"N Engl J Med","first-page":"2257","article-title":"Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis","volume":"356","author":"Weinstein","year":"2007"},{"key":"b30-focus15441","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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