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Coflex 棘突间动态稳定系统治疗腰椎管狭窄症:长期随访结果

Coflex interspinous process dynamic stabilization for lumbar spinal stenosis: Long-term follow-up.

机构信息

Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an, 710038; Preclinical School of Medicine, The Fourth Military Medical University, Xi'an 710032, China.

Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an, 710038.

出版信息

J Clin Neurosci. 2020 Nov;81:462-468. doi: 10.1016/j.jocn.2020.09.040. Epub 2020 Nov 1.

Abstract

OBJECTIVE

To evaluate the long-term efficacy of Coflex dynamic stabilization device in the treatment of lumbar spinal stenosis.

METHODS

The clinical and imaging data of 73 patients undergoing Coflex dynamic stabilization surgery from July 2008 to June 2012 were retrospectively analyzed. All patients had a minimum of 8 years of follow-up. Clinical data were used to assess the clinical efficacy, and radiographic parameters were measured for evaluation of ASD.

RESULTS

56 Patients were followed up for 107.6 ± 13.3 months. The visual analogue scale of pain (VAS), Owestry disability index (ODI) and Japanese Orthopedic Association Scores (JOA) improved significantly after surgery. At 6 months after surgery and the last follow-up, lumbar range of motion (ROM) was significantly lower than that before surgery (P < 0.001). ROM was slightly increased at the last follow-up compared with that 6 months after operation (P > 0.05). ROM of adjacent segments increased at 6 months and at the last follow-up compared with that before surgery (P > 0.05). At 6 months after surgery, intervertebral space height (ISH) and intervertebral foramen height (IFH) of implanted segment was significantly higher than that before surgery (P < 0.05). At the last follow-up, there was a decrease in ISH and IFH (P > 0.05). During the follow-up period, a total of 11 patients (19.6%) experienced complications and 6 patients (10.7%) underwent secondary surgery.

CONCLUSION

Coflex interspinous process dynamic stabilization is effective in the long-term treatment of lumbar spinal stenosis, the ISH and IFH of implanted segment could be increased in a short period of time.

摘要

目的

评估 Coflex 动态稳定装置治疗腰椎管狭窄症的长期疗效。

方法

回顾性分析 2008 年 7 月至 2012 年 6 月行 Coflex 动态稳定手术的 73 例患者的临床和影像学资料。所有患者随访时间均至少 8 年。采用临床资料评估临床疗效,影像学参数评估 ASD。

结果

56 例患者获得 107.6±13.3 个月的随访。术后患者疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)和日本骨科协会评分(JOA)均显著改善。术后 6 个月及末次随访时,腰椎活动度(ROM)明显低于术前(P<0.001)。末次随访时 ROM 较术后 6 个月时略有增加(P>0.05)。与术前相比,术后 6 个月及末次随访时相邻节段 ROM 均增加(P>0.05)。术后 6 个月,植入节段的椎间间隙高度(ISH)和椎间孔高度(IFH)明显高于术前(P<0.05)。末次随访时,ISH 和 IFH 下降(P>0.05)。随访期间,共有 11 例(19.6%)患者发生并发症,6 例(10.7%)患者行二次手术。

结论

Coflex 棘突间动态稳定系统治疗腰椎管狭窄症长期疗效确切,短期内可增加植入节段的 ISH 和 IFH。

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