Zheng Xiaoqing, Chen Zhida, Yu Honglong, Zhuang Jianxiong, Yu Hui, Chang Yunbing
Department of Orthopaedics, Guangdong Provincial People's Hospital, Guangzhou, Guangdong 510030, P.R. China.
Department of Orthopaedics, The 909th Hospital of People's Liberation Army, The Affiliated Southeast Hospital of Xiamen University, Orthopedic Center of People's Liberation Army, Zhangzhou, Fujian 363000, P.R. China.
Exp Ther Med. 2021 Jun;21(6):595. doi: 10.3892/etm.2021.10027. Epub 2021 Apr 9.
The current study aimed to compare the outcomes of decompression and interlaminar stabilisation with those of decompression and fusion for the treatment of lumbar degenerative disease (LDD) at a minimum 8-year follow-up. The current study also aimed to analyse the risk factors of radiographic adjacent segment degeneration (ASD). A total of 82 consecutive patients with LDD who underwent surgery between June 2007 and February 2011 were retrospectively reviewed. Of these patients, 39 underwent decompression and Coflex interspinous stabilisation (Coflex group) and 43 underwent decompression and posterior lumbar interbody fusion (PLIF) (PLIF group). All patients had a minimum of 8-years of follow-up data. Radiographic and clinical outcomes were compared between the groups, and the risk factors of developing radiographic ASD were also evaluated. The Oswestry disability index and visual analogue scale leg and back pain scores of both groups significantly improved compared with the baseline (all P<0.05), and no difference were indicated between the two groups at each follow-up time point (P>0.05). The Coflex group exhibited preserved mobility (P<0.001), which was associated with a decreased amount of blood loss (P<0.001), shorter duration of surgery (P=0.001), shorter duration of hospital stay and a lower incidence of ASD (12.8 vs. 32.56%; P=0.040) compared with the fusion group. The current study indicated that coflex and fusion technologies are safe and effective for the treatment of LDD, based on long-term follow-up data. However, Coflex interspinous stabilisation was revealed to reduce ASD incidence. Under strict indications, Coflex interspinous stabilisation is an effective and safe treatment method.
本研究旨在比较减压与椎板间稳定术和减压与融合术治疗腰椎退行性疾病（LDD）的疗效，随访时间至少为8年。本研究还旨在分析影像学相邻节段退变（ASD）的危险因素。对2007年6月至2011年2月期间连续接受手术的82例LDD患者进行回顾性分析。其中，39例接受减压和Coflex棘突间稳定术（Coflex组），43例接受减压和后路腰椎椎间融合术（PLIF）（PLIF组）。所有患者均有至少8年的随访数据。比较两组的影像学和临床疗效，并评估发生影像学ASD的危险因素。与基线相比，两组的Oswestry功能障碍指数、视觉模拟量表腿痛和背痛评分均显著改善（均P<0.05），且在各随访时间点两组间无差异（P>0.05）。与融合组相比，Coflex组的活动度得以保留（P<0.001），这与失血量减少（P<0.001）、手术时间缩短（P=0.001）、住院时间缩短及ASD发生率较低（12.8%对32.56%；P=0.040）相关。基于长期随访数据，本研究表明Coflex和融合技术治疗LDD安全有效。然而，Coflex棘突间稳定术可降低ASD发生率。在严格的适应症下，Coflex棘突间稳定术是一种有效且安全的治疗方法。
