Posterior dynamic topping-off fusion stabilization system in lumbosacral spine: a review of different instrumentation techniques

M. Mesbah, A. Barkaoui, H. Chiali, M. Bendoukha

Abstract: Posterior dynamic topping off fusion stabilization is a new concept applying fusion at one or more index levels, and non-fusion stabilization at a supra-adjacent level. This technique is suggested to address adjacent segment disease (ASD) in the lumbosacral spine, which is considered to be a fusion-related phenomenon for some patients. The dynamic topping off fusion system is designed to maintain segment stability and preserve segment mobility. In this paper, we review the literature and discuss the effect of this technique in avoiding post-fusion ASD. This stabilization is the future of spinal surgery to stabilize the spine without post-surgery incidences. In the last years, a remarkable dynamic topping off fusion instrumentation was used to improve stabilization. Despite the increasing use of this system, few prospective studies evaluated the results and convenience of this technique. It is important to follow the development of these technologies; and discussing in detail, lessons and gained experience using them.

Series on Biomechanics, Vol.34, No.1 (2020), 41-47

Keywords: adjacent segment disease; flexible fixation; spinal surgery; topping off fusion

Date published: 2020-04-03