(1) Wansbeck General Hospital, Northumbria Healthcare NHS Trust, UK
(2) Teesside University, Middlesbrough, UK
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Dynamic stabilization in degenerative spondylolisthesis is a relatively new concept and has been designed to overcome the negative effects of spinal fusion, i.e. increase in spine stiffness, chronic back pain and acceleration of degenerative process at the adjacent levels.
To our knowledge and to date, this is the first systematic review presenting the results of an evaluation of the clinical effectiveness of dynamic stabilization devices in patients with degenerative lumbar spondylolisthesis as the sole diagnosis.
Materials and methods
A detailed search was conducted through several databases (up to February 2013): MEDLINE, CINAHL, AMED, British Nursing Index, SPORTDiscus, EMBASE and Journals@Ovid; an extensive handsearch, including grey literature and reference lists of the articles was conducted. The methodological assessment was performed by two reviewers using the McMaster University framework.
The search identified a total of 493 titles. Ten studies were included in the final review of which only one was a randomized controlled trial. The reported validated clinical outcome measures were: Oswestry Disability Index, Short Form - 36, Visual Analogue Score for back and leg pain and Patient Satisfaction Index. Each study reported a statistically significant improvement of the outcome measures.
Although the results of dynamic stabilization in degenerative spondylolisthesis are encouraging, the authors cannot safely recommend the use of these devices to the general population as yet due to the moderate methodological quality of the included primary papers. The authors recommend that future research should include properly designed randomized controlled studies, preferably multi-centred, demonstrating solid methodology.