Liu Jin, Liu Hao, Li Guang-hui, Song Yue-ming, Li Tao, Zeng Jian-cheng
Department of Orthopaedics, Westchina Hospital of Sichuan University, Chengdu 610041, China.
Zhonghua Wai Ke Za Zhi. 2013 Feb 1;51(2):142-6.
To summarize the mid-term effectiveness of Coflex non-fusion internal fixation treatment of degenerative lumbar disease.
From October 2008 to December 2010, a retrospective analysis was carried out on 39 patients (29 males and 10 females) diagnosed as degenerative lumbar disease and treated with Coflex interspinous dynamic device, who had been followed up for 1 year at least, the average age was 45.5 years (range, 23 - 67 years). The results were assessed by Japanese Orthopedic Association (JOA) scores, visual analogue scale (VAS) scores, Oswestry disability index (ODI) scores and SF-36 scores; and the range of mobility (ROM), intervertebral disc height of the responsible and adjacent segments were measured on X-film before the operation and at last follow-up. Observed the therapeutic effect of the patients and compared the effect on the patients of different body mass index (BMI) and different age by the One-way analysis of variance and paired t test.
The 39 patients were followed up for 30.9 months (range, 12 - 37 months). At the last follow-up, JOA, ODI, VAS and SF-36 scores were improved by 70% ± 12%, 54% ± 12%, 77% ± 10% and 51% ± 9%, and were statistically significant (t = -33.289, 26.448, 26.596 and -20.772, P = 0.00). Patients with BMI ≥ 25 kg/m(2) had lower improvement rates in the scores than those with BMI < 25 kg/m(2) (F = 10.561, 5.850, 5.651 and 6.519, P < 0.05). The patients were 50 years older or younger couldn't affected the improvement rates in the scores statistically (P > 0.05). There were no significant difference in remaining disc height (P > 0.05), except that the intervertebral disc height of L4-5 increased slightly compared with the preoperative (t = -2.819, P = 0.008). In addition to the ROM of L3-4, L5-S1 and L1-S1 were not significantly different from the preoperative(P > 0.05), the ROM of L4-5 were decreased (t = 12.598, P = 0.000).
The mid-term effectiveness of Coflex non-fusion interspinous fixation in treatment of degenerative lumbar disease is worthy of recognition, and Coflex combined with Isobar has advantages in the treatment of multi-segment degenerative lumbar disease.
总结Coflex非融合内固定治疗退行性腰椎疾病的中期疗效。
回顾性分析2008年10月至2010年12月间39例诊断为退行性腰椎疾病并接受Coflex棘突间动力装置治疗的患者（男29例，女10例），均至少随访1年，平均年龄45.5岁（23 - 67岁）。采用日本骨科协会（JOA）评分、视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）评分及SF - 36评分评估结果；于术前及末次随访时在X线片上测量责任节段及相邻节段的活动度（ROM）、椎间盘高度。观察患者治疗效果，并通过单因素方差分析和配对t检验比较不同体重指数（BMI）及不同年龄患者的疗效。
39例患者随访30.9个月（12 - 37个月）。末次随访时，JOA、ODI、VAS及SF - 36评分分别提高70%±12%、54%±12%、77%±10%及51%±9%，差异有统计学意义（t = -33.289、26.448、26.596及 -20.772，P = 0.00）。BMI≥25 kg/m²的患者评分改善率低于BMI<25 kg/m²的患者（F = 10.561、5.850、5.651及6.519，P<0.05）。年龄50岁及以下的患者评分改善率差异无统计学意义（P>0.05）。除L4 - 5椎间盘高度较术前略有增加（t = -2.819，P = 0.008）外，其余椎间盘高度差异无统计学意义（P>0.05）。除L3 - 4的ROM外，L5 - S1及L1 - S1的ROM与术前相比差异无统计学意义（P>0.05），L4 - 5的ROM降低（t = 12.598，P = 0.000）。
Coflex非融合棘突间固定治疗退行性腰椎疾病的中期疗效值得肯定，Coflex联合Isobar在多节段退行性腰椎疾病治疗中具有优势。
