Dynamic stabilization with the Dynesys® system and the dynamic transition option DTO™ implant: philosophy — concept — surgical technique

The degenerative cascade in the lombar spine can go through a phase of destabilization where abnormal motion due to the loss of segmental rigidity can cause pain, be it low back pain or redicular pain. In this phase where lesions still allow for some motion and before natural restabilization, dynamic stabilization is a treatment that allows for bringing the spine back into a pain free situation. After 14 years of clinical use and almost 40 000 patient treated with dynamic stabilization, Dynesys® has clearly defined its field of application as well as its limitations. We will reported the surgical techniques and clinical results and shown the evolution of the device with open screws and DTO™ system, which permits fused and non-fused solution in the same patient with an “on line” device.