Celik Haydar, Derincek Alihan, Koksal Ismet
M.H. Beypazarı State Hospital, Department of Neurosurgery, Ankara, Turkey.
Turk Neurosurg. 2012;22(1):50-4. doi: 10.5137/1019-5149.JTN.4681-11.2.
The aim of implantation of interspinous device is to unload the facet joints, restore foraminal height and provide stability in order to improve the clinical outcome of surgery.
After microsurgical decompression, Coflex™ device was applied. Patients were evaluated at a month after surgery and last follow-up using the visual analogue scale (VAS) and Oswestry Disability Index (ODI). Foraminal height and lumbar lordosis angle were recorded.
The mean preoperative VAS was 7.85 and fell to 1.7 a month after surgery (p < 0.0001). At the last follow-up the mean VAS score was 1.65 (p < 0.0001). The mean foraminal heights were measured 19.95 mm preoperatively and 25.05 mm a month after surgery (p < 0.0001). The mean foraminal height was 21.60 mm at the last follow-up (p=0.002). The mean lumbar lordosis were measured 32.05 and 34.3 degrees at preoperative and a month after surgery respectively (p=0.155). The mean lumbar lordosis was 32 (±5.99) degrees at the last follow-up (p=0.974).
Using the Coflex device is a minimal invasive, effective and safe procedure. Restoration of the foraminal height may not be a responsible factor for clinical improvement. We think microsurgical decompression looks responsible of the good clinical outcome and using interspinous device is unnecessary. Comparative clinical studies can be informative.
植入棘突间装置的目的是减轻小关节负荷、恢复椎间孔高度并提供稳定性，以改善手术的临床效果。
在进行显微减压术后，应用Coflex™装置。在术后1个月及末次随访时，使用视觉模拟评分法（VAS）和奥斯维斯特里功能障碍指数（ODI）对患者进行评估。记录椎间孔高度和腰椎前凸角。
术前VAS平均为7.85，术后1个月降至1.7（p<0.0001）。在末次随访时，VAS平均评分为1.65（p<0.0001）。术前椎间孔平均高度为19.95mm，术后1个月为25.05mm（p<0.0001）。末次随访时椎间孔平均高度为21.60mm（p=0.002）。术前和术后1个月腰椎前凸平均分别为32.05°和34.3°（p=0.155）。末次随访时腰椎前凸平均为32（±5.99）°（p=0.974）。
使用Coflex装置是一种微创、有效且安全的手术方法。椎间孔高度的恢复可能不是临床改善的责任因素。我们认为显微减压似乎是良好临床效果的原因，使用棘突间装置是不必要的。比较性临床研究可能会提供有用信息。
