{"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":1779527243358,"version":"3.53.1"},"reference-count":48,"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 The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Patients who underwent monosegmental surgery at L4\u20135 with nonfusion dynamic stabilization using the Dynesys system (Dynesys group) or transforaminal lumbar interbody fusion with pedicle screw fixation (fusion group) were retrospectively compared. Facet joint degeneration was evaluated at each segment using the CT grading system.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The Dynesys group included 15 patients, while the fusion group included 22 patients. The preoperative facet joint degeneration CT grades were not different between the 2 groups. Compared with the preoperative CT grades, 1 side of the facet joints at L3\u20134 and L4\u20135 had significantly more degeneration in the Dynesys group. In the fusion group, significant facet joint degeneration developed on both sides at L2\u20133, L3\u20134, and L5\u2013S1. The subjective back and leg pain scores were not different between the 2 groups during follow-up, but functional outcome based on the Oswestry Disability Index improved less in the fusion group than in the Dynesys group.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Nonfusion dynamic stabilization using the Dynesys system had a greater preventative effect on facet joint degeneration in comparison with that obtained using fusion surgery. The Dynesys system, however, resulted in facet joint degeneration at the instrumented segments and above. An improved physiological nonfusion dynamic stabilization system for lumbar spinal surgery should be developed.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2015.10.focus15456","type":"journal-article","created":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T03:36:37Z","timestamp":1451619397000},"page":"E6","source":"Crossref","is-referenced-by-count":12,"title":["Facet joint changes after application of lumbar nonfusion dynamic stabilization"],"prefix":"10.3171","volume":"40","author":[{"given":"Soo Eon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Seoul National University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae-Ahn","family":"Jahng","sequence":"additional","affiliation":[{"name":"Seoul National University and Bundang Hospital; and"},{"name":"Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jib","family":"Kim","sequence":"additional","affiliation":[{"name":"Seoul National University and Bundang Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus15456","series-title":"Pain Physician","first-page":"229","article-title":"A systematic review of therapeutic facet joint interventions in chronic spinal pain","volume":"10","author":"Boswell","year":"2007"},{"key":"b2-focus15456","series-title":"Spine (Phila Pa 1976)","first-page":"2868","article-title":"Does superior-segment facet violation or laminectomy destabilize the adjacent level in lumbar transpedicular fixation? An in vitro human cadaveric assessment","volume":"33","author":"Cardoso","year":"2008"},{"key":"b3-focus15456","series-title":"Eur Spine J","first-page":"1476","article-title":"Technical factors related to the incidence of adjacent superior segment facet joint violation after transpedicular instrumentation in the lumbar spine","volume":"17","author":"Chen","year":"2008"},{"key":"b4-focus15456","series-title":"Spine (Phila Pa 1976)","first-page":"S110","article-title":"Biomechanical evaluation of total disc replacement arthroplasty: an in vitro human cadaveric model","volume":"28","author":"Cunningham","year":"2003"},{"key":"b5-focus15456","series-title":"Pain Physician","first-page":"437","article-title":"Systematic assessment of diagnostic accuracy and therapeutic utility of lumbar facet joint interventions","volume":"12","author":"Datta","year":"2009"},{"key":"b6-focus15456","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-focus15456","series-title":"Spine J","first-page":"85","article-title":"Comparison of the biomechanical effect of pedicle-based dynamic stabilization: a study using finite element analysis","volume":"13","author":"Jahng","year":"2013"},{"key":"b8-focus15456","series-title":"J Spinal Disord Tech","first-page":"60","article-title":"Comparisons of outcomes after single or multilevel dynamic stabilization: effects on adjacent segment","volume":"24","author":"Kim","year":"2011"},{"key":"b9-focus15456","series-title":"J Spinal Disord Tech","first-page":"219","article-title":"Influence of facet and posterior muscle degeneration on clinical results of lumbar total disc replacement: two-year follow-up","volume":"18","author":"Le Huec","year":"2005"},{"key":"b10-focus15456","series-title":"J Korean Neurosurg Soc","first-page":"221","article-title":"Clinical experience of the dynamic stabilization system for the degenerative spine disease","volume":"43","author":"Lee","year":"2008"},{"key":"b11-focus15456","series-title":"J Spinal Disord Tech","first-page":"410","article-title":"Influence of Dynesys system screw profile on adjacent segment and screw","volume":"23","author":"Liu","year":"2010"},{"key":"b12-focus15456","series-title":"Eur Spine J","first-page":"1480","article-title":"Kinematic evaluation of the adjacent segments after lumbar instrumented surgery: a comparison between rigid fusion and dynamic non-fusion stabilization","volume":"20","author":"Morishita","year":"2011"},{"key":"b13-focus15456","series-title":"Spine (Phila Pa 1976)","first-page":"2624","article-title":"Computed tomography evaluation of superior-segment facet-joint violation after pedicle instrumentation of the lumbar spine with a midline surgical approach","volume":"31","author":"Moshirfar","year":"2006"},{"key":"b14-focus15456","series-title":"Spine (Phila Pa 1976)","first-page":"19","article-title":"The effect of dynamic posterior stabilization on facet joint contact forces: an in vitro investigation","volume":"33","author":"Niosi","year":"2008"},{"key":"b15-focus15456","series-title":"Eur Spine J","first-page":"913","article-title":"Biomechanical characterization of the three-dimensional kinematic behaviour of the Dynesys dynamic stabilization system: an in vitro study","volume":"15","author":"Niosi","year":"2006"},{"key":"b16-focus15456","series-title":"Eur Spine J","first-page":"1223","article-title":"Comparison of the effects of bilateral posterior dynamic and rigid fixation devices on the loads in the lumbar spine: a finite element analysis","volume":"16","author":"Rohlmann","year":"2007"},{"key":"b17-focus15456","series-title":"Presse Med","first-page":"1447","article-title":"[Osteosynthesis of dorsal, lumbar, and lumbosacral spine with metallic plates screwed into vertebral pedicles and articular apophyses.]","volume":"78","author":"Roy-Camille","year":"1970"},{"key":"b18-focus15456","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":"b19-focus15456","series-title":"J Spinal Disord Tech","first-page":"418","article-title":"Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment","volume":"16","author":"Schmoelz","year":"2003"},{"key":"b20-focus15456","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":"b21-focus15456","series-title":"Spine (Phila Pa 1976)","first-page":"272","article-title":"Radiologic evaluation of adjacent superior segment facet joint violation following transpedicular instrumentation of the lumbar spine","volume":"28","author":"Shah","year":"2003"},{"key":"b22-focus15456","series-title":"Eur Spine J","first-page":"174","article-title":"A prospective morphological study of facet joint integrity following intervertebral disc replacement with the CHARIT\u00c9 Artificial Disc","volume":"15","author":"Trouillier","year":"2006"},{"key":"b23-focus15456","series-title":"Skeletal Radiol","first-page":"215","article-title":"MR imaging and CT in osteoarthritis of the lumbar facet joints","volume":"28","author":"Weishaupt","year":"1999"},{"key":"b24-focus15456","series-title":"Clin Biomech (Bristol, Avon)","first-page":"767","article-title":"Effect of a posterior dynamic implant adjacent to a rigid spinal fixator","volume":"21","author":"Zander","year":"2006"},{"key":"b1-focus15456","series-title":"Pain Physician","first-page":"229","article-title":"A systematic review of therapeutic facet joint 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An in vitro human cadaveric assessment","volume":"33","author":"Cardoso","year":"2008"},{"key":"b3-focus15456","series-title":"Eur Spine J","first-page":"1476","article-title":"Technical factors related to the incidence of adjacent superior segment facet joint violation after transpedicular instrumentation in the lumbar spine","volume":"17","author":"Chen","year":"2008"},{"key":"b4-focus15456","series-title":"Spine (Phila Pa 1976)","first-page":"S110","article-title":"Biomechanical evaluation of total disc replacement arthroplasty: an in vitro human cadaveric model","volume":"28","author":"Cunningham","year":"2003"},{"key":"b5-focus15456","series-title":"Pain Physician","first-page":"437","article-title":"Systematic assessment of diagnostic accuracy and therapeutic utility of lumbar facet joint interventions","volume":"12","author":"Datta","year":"2009"},{"key":"b6-focus15456","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-focus15456","series-title":"Spine J","first-page":"85","article-title":"Comparison of the biomechanical effect of pedicle-based dynamic stabilization: a study using finite element analysis","volume":"13","author":"Jahng","year":"2013"},{"key":"b8-focus15456","series-title":"J Spinal Disord Tech","first-page":"60","article-title":"Comparisons of outcomes after single or multilevel dynamic stabilization: effects on adjacent segment","volume":"24","author":"Kim","year":"2011"},{"key":"b9-focus15456","series-title":"J Spinal Disord Tech","first-page":"219","article-title":"Influence of facet and posterior muscle degeneration on clinical results of lumbar total disc replacement: two-year follow-up","volume":"18","author":"Le Huec","year":"2005"},{"key":"b10-focus15456","series-title":"J Korean Neurosurg Soc","first-page":"221","article-title":"Clinical experience of the dynamic 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1976)","first-page":"19","article-title":"The effect of dynamic posterior stabilization on facet joint contact forces: an in vitro investigation","volume":"33","author":"Niosi","year":"2008"},{"key":"b15-focus15456","series-title":"Eur Spine J","first-page":"913","article-title":"Biomechanical characterization of the three-dimensional kinematic behaviour of the Dynesys dynamic stabilization system: an in vitro study","volume":"15","author":"Niosi","year":"2006"},{"key":"b16-focus15456","series-title":"Eur Spine J","first-page":"1223","article-title":"Comparison of the effects of bilateral posterior dynamic and rigid fixation devices on the loads in the lumbar spine: a finite element analysis","volume":"16","author":"Rohlmann","year":"2007"},{"key":"b17-focus15456","series-title":"Presse Med","first-page":"1447","article-title":"[Osteosynthesis of dorsal, lumbar, and lumbosacral spine with metallic plates screwed into vertebral pedicles and articular 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