中山大学学报（医学科学版）2011，Vol.32Issue(3)：364-369,6.
Coflex棘突间植入与后路椎间融合固定治疗单节段腰椎退行性疾病的对比研究
Treatment of Single Degenerative Disc Disease with Coflex Interspinous Implant and Posterior Lumbar Interbody Fusion: a Comparative Analysis
摘要
Abstract
[ Objective ]To study the clinical effects of single Coflex interspinous implant on the treatment of degenerative disc disease (DDD). [Methods] From June 2008 to December 2009 ninety-two degenerative disc disease patients who were accorded with the entry and removal value were divided into two groups randomly also by considering their desire. 21 cases were treated with single Coflex interspinous implant (Coflex group) and 71 cases with posterior lumbar intervertebral fusion (PLIF group). The hospital stay, operative time, blood loss and complications of all cases were surveyed. Low back pain (LBP) and leg pain at preoperative and final follow-up were evaluated according to VAS scales, and the Oswestry Disability Index (ODI) was recorded to evaluate the function. Flexion-extension radiographs were taken separately and range of motion (ROM ) of the instrumented level and upper adjacent were measured. We compared the hospital stay, operative time, blood loss between the two groups. At the same time, VAS scales of LBP and leg pain, ODI, ROM of the instrumented level and upper adjacent were also compared in and between groups. [ Results ] Hospital stay, operative time and blood loss in the Coflex group were significantly less than those in the group of PLIF (P < 0.01). VAS scales of LBP and leg pain,ODI of the final follow-up were significantly lower than preoperative in both groups (P < 0.01). Between the two groups, however, there were no significant differences neither at preoperative or final follow-up (P > 0.05). It achieved bone fusion in the group of PLIF at the final follow-up, although ROM of the instrumented level at the final follow-up in the group of Coflex was similar to the preoperative(P = 0.70). It was significantly higher in terms of ROM of the instrumented level at the final follow-up in the group of Coflex (P < 0.01), but no significant differences were found in terms of ROM at preoperative between groups (P = 0.50). ROM at the upper adjacent level at the final follow-up in the group of Coflex was similar to the preoperative (P= 0.63), whereas that in group of PLIF was markedly increased at the final follow-up(P = 0.02), compared with preoperative. It was significantly higher in terms of ROM of segment of adjacent upper operation at the final follow-up in the group of PLIF (P = 0.02), though no significant differences were found in terms of ROM at preoperative between groups (P = 0.61).[Conclusion] There is no significant differences between single Coflex interspinous implant treated for DDD and posterior interbody fusion in improving clinical symptoms. But hospital stay, operative time, blood loss were less in the single Coflex interspinous implant groups than those in posterior interbody fusion groups. Coflex interspinous implant not only provides control but not limited activity of the surgery segment, but also effectively reduces the activity of the adjacent segment.关键词
腰椎/椎间盘退行性疾病/Coflex/后路椎间融合Key words
lumbar/ degenerative disc disease/ Coflex/ posterior lumbar interbody fusion分类
医药卫生引用本文复制引用
林宏生,张国威,吴昊,刘宁,查振刚..Coflex棘突间植入与后路椎间融合固定治疗单节段腰椎退行性疾病的对比研究[J].中山大学学报（医学科学版）,2011,32(3):364-369,6.基金项目
澳门科学技术发展基金(026/2010/A)；广东省科技计划项目(2010-170-1) （026/2010/A）
