中国骨伤2011，Vol.24Issue(4)：277-281,5.DOI:10.3969/j.issn.1003-0034.2011.04.003
腰椎融合联合Coflex动态固定手术治疗腰椎退行性疾病
Spinal fusion combined with dynamic interspinous fixation with Coflex system for lumbar degenerative disease
摘要
Abstract
Objective:To summarize the effect of the implantation of Coflex interspious stabilization device combined with spinal fusion for the treatment of lumbar degenerative disease.Methods: From March 2008 to March 2010, 1 8 patients with two levels lumbar degenerative disease were treated with spinal fusion and dynamic interspinous fixation with Coflex system. There were 11 males and 7 females. The average age was 50.2 years (range 41 to 62 years). The VAS and the Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at last follow-up. Range of motion (ROM) and disc height index (DHI) were recorded.Results:All patients were followed up for 12 months averagely (range 6-30 months). At final follow-up, leg VAS, back V AS and ODI functional score were significant improved than those of preoperation [ back VAS: 1.50±0.90 vs 7.20±0.90; leg VAS: 1.10±0.80 vs 5.20±0.90; ODI functional score: (15.90±5.80) ％ vs (52.50±5.90)％ ]. The DHI increased from 0.23±0.05 preoperatively to 0.35±0.06 postoperatively and to 0.33±0.04 at final follow-up, the height of intervertebral space were not found significant loss. The ROM at the Coflex stabilized levels on the X-ray views was (8.90± 1.80) ° preoperatively, (8.30± 1.90) ° postoperatively,and (8. 1 0± 1.80) ° at final follow-up. There was no significant difference between final follow-up and preoperative (P=0.19). The ROM of the lumbar spine (L2-S1) was (20.20±5.60) ° preoperatively, (14.40±5.70) ° postoperatively, and (15.50±5.20) ° at final follow-up. There was significant reduction of the L2-S1 ROM at final follow-up(P=0.01 ). Conclusion: Posterior interspinous stabilization with Coflex system combined with spinal fusion can obtain satisfactory outcomes for patients with two levels lumbar degenerative disease in the short follow-up duration. Nevertheless, no overwhelming evidence suggested that the system is better than traditional fusion at present. The selection of surgical indication is important for the treatment of lumbar degenerative disease.关键词
腰椎/退行性疾病/脊柱融合术/脊柱非融合术/动态固定Key words
Lumbar vertebrae/ Degenerative disease/ Spinal fusion/ Spinal non-fusion/ Dynamic fixation引用本文复制引用
李忠海,王诗媛,唐昊,马辉,张秋林,侯铁胜..腰椎融合联合Coflex动态固定手术治疗腰椎退行性疾病[J].中国骨伤,2011,24(4):277-281,5.基金项目
上海市科委医学重点项目(编号:09411952900) （编号:09411952900）
