Dynamic instrumentation of the lumbar spine. Clinical and biomechanical analysis of success factors

摘要: Total disc replacement and posterior dynamic stabilization represent alternatives to lumbar spinal fusion which should reduce the risk of adjacent segment degeneration. Disc is indicated for pure discopathy without facet joint Spinopelvic balance influences implant's biomechanics. Therefore pelvic incidence, sacral slope, segmental lordosis mean axis rotation need be considered. Dynamic in moderate degeneration, degenerative spondylolisthesis grade I with a hypermobile stenosis. The combination caudal cranial allows better maintenance multiple level instrumentation prevents If incidence slope are high, L5-S1 fused because elevated shear forces.