{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T05:19:07Z","timestamp":1787375947802,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Multisegmental lumbar degenerative disease (ms-LDD) is a common condition in older adults, often requiring surgical intervention. While rigid stabilization remains the gold standard, it is associated with complications such as adjacent segment disease (ASD), higher blood loss, and longer recovery times. The Dynesys dynamic stabilization system offers an alternative by preserving motion while stabilizing the spine. However, data comparing Dynesys with fusion in multisegmental cases are limited. Objective: This study evaluates the clinical and radiographic outcomes of Dynesys dynamic stabilization versus rigid stabilization in the treatment of ms-LDD. Methods: A retrospective analysis was conducted on 53 patients (mean age: 62.25 \u00b1 15.37 years) who underwent either Dynesys dynamic stabilization (n = 27) or PLIF (n = 26) for ms-LDD involving at least seven motion segments. Clinical outcomes were assessed using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), while radiological parameters such as lumbar lordosis (LL), sagittal vertical axis (SVA), and spinopelvic parameters (pelvic incidence, pelvic tilt and, sacral slope) were analyzed. A two-stage surgical approach was employed in the Dynesys group to enhance osseointegration, particularly in elderly osteoporotic patients. Results: Both groups showed significant improvements in VAS and ODI scores postoperatively (p &lt; 0.001), with no significant differences between them. However, the Dynesys group demonstrated superior sagittal alignment correction, with a significant increase in LL (p &lt; 0.002) and a significant decrease in SVA (p &lt; 0.0015), whereas changes in the rigid stabilization group were not statistically significant. Additionally, the Dynesys group had fewer complications, including a lower incidence of ASD (0 vs. 6 cases). The two-stage technique facilitated improved screw osseointegration and reduced surgical risks in osteoporotic patients. Conclusions: Dynesys dynamic stabilization is an effective alternative to rigid stabilization in ms-LDD, offering comparable pain relief and functional improvement while preserving motion and reducing ASD risk. The two-stage approach enhances long-term stability, making it particularly suitable for elderly or osteoporotic patients. Further long-term studies are needed to confirm these findings.<\/jats:p>","DOI":"10.3390\/jcm14155472","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T08:46:55Z","timestamp":1754383615000},"page":"5472","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Dynamic vs. Rigid: Transforming the Treatment Landscape for Multisegmental Lumbar Degeneration"],"prefix":"10.3390","volume":"14","author":[{"given":"Caner","family":"Gunerbuyuk","sequence":"first","affiliation":[{"name":"Spine Center, Koc University Hospital, 34010 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1342-7663","authenticated-orcid":false,"given":"Mehmet Yigit","family":"Akgun","sequence":"additional","affiliation":[{"name":"Spine Center, Koc University Hospital, 34010 Istanbul, Turkey"},{"name":"Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey"},{"name":"Biomechanics and Endurance Laboratory, Koc University Research Center for Translational Medicine, 43606 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7577-3411","authenticated-orcid":false,"given":"Nazenin","family":"Durmus","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3672-7343","authenticated-orcid":false,"given":"Ege Anil","family":"Ucar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helin Ilkay","family":"Orak","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tunc","family":"Oktenoglu","sequence":"additional","affiliation":[{"name":"Spine Center, Koc University Hospital, 34010 Istanbul, Turkey"},{"name":"Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozkan","family":"Ates","sequence":"additional","affiliation":[{"name":"Spine Center, Koc University Hospital, 34010 Istanbul, Turkey"},{"name":"Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey"},{"name":"Biomechanics and Endurance Laboratory, Koc University Research Center for Translational Medicine, 43606 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turgut","family":"Akgul","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Istanbul University, 34730 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali fahir","family":"Ozer","sequence":"additional","affiliation":[{"name":"Spine Center, Koc University Hospital, 34010 Istanbul, Turkey"},{"name":"Department of Neurosurgery, Koc University Hospital, 34010 Istanbul, Turkey"},{"name":"Biomechanics and Endurance Laboratory, Koc University Research Center for Translational Medicine, 43606 Istanbul, Turkey"},{"name":"Bioengineering and Orthopaedic Surgery Colleges of Engineering and Medicine, University of Toledo, Toledo, OH 43606, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1177\/0300060517708104","article-title":"Medium-term effects of Dynesys dynamic stabilization versus posterior lumbar interbody fusion for treatment of multisegmental lumbar degenerative disease","volume":"45","author":"Wu","year":"2017","journal-title":"J. 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