Rehabilitation in the dynamic stabilization of the lumbosacral spine

Until recently in the field of vertebral surgery, many diseases weremanaged with surgery of instrumented vertebral stabilizationand bone fusion (arthrodesis). Fusion always offered valid and saferesults, although at the expense of the abolition of the motilityof the spine section which was being operated uponFor this reason, when treating degenerative diseases of the lumbosacralspine, the Orthopaedic Clinic of the S. Chiara Hospital in Pisa,introduced the Dynesys® lumbosacral spine dynamic neutralizationsystem to treat patients and spinal diseases with selectedindications.Dynesys is a non-fusion elastic system with transpedicular screwsand a flexible connector for dynamic stabilization. This is a newmethod for treating the degenerative disease of the lumbosacralspine which preserves motility at the treated levels. While allowingfor movement of the segment at all levels, the Dynesys providesstability to the functional unit, which attains a condition of physiologicalfunction compared with the rigid stabilization-arthrodesis.This publication, which describes the indications and the variousphases of technical rehabilitation to be used after surgical treatmentof lumbar degenerative spine, represents a work of fundamentalimportance that is clearly useful to those interested in this areaof orthopaedics.The pathologies treated are: disc bulging and micro-instabilitywith lumbar pain and irritating sciatica; herniated disc and microinstabilityof one level with irritating lumbar-sciatic pain; spondylosiswith stenosis affecting at least two levels; degenerativespondylolisthesisof one level up to grade 2; repeated surgery ona herniated disc at one or two levels; rotational scoliosis of moderategrade in adults.