The treatment of degenerative lumbar spinal stenosis with Coflex system / 中华骨科杂志

ABSTRACT

Objective To investigate the clinical value of spinal nonfusion interspinous Coflex system for the degenerative lumbar spinal stenosis.Methods From March 2008 to August 2009,26 patients with degenerative lumbar spinal stenosis were treated by decompression with posterior spinous process and interspinous implant Coflex folder method,including 11 males and 15 females,with the mean age of 65.4years(range,45-78 years).L3,4 segment in 7 cases,L4,5 segment in 13 cases,concomitant L3,4,L4,5 segment stenosis in 6 cases.Patients were scanned by MRI and CT confirmed L3,4 and(or)L4,5 segments of the ligamentum flavum thickening,proliferation of small-joint bone,merger disc herniation causing central tube and lateral fossae stricture,nerve root or coccygeal plexus compression.Lumbar anteroposterior,lateral and flexion-extension X-ray films preoperatively,and at follow-up were used to measure the following parameters by eFilm and CAD softwarethe anterior and posterior disc space height,the range of motion at surgical level,and the segment of the spinal canal area of responsibility.Postoperative standard Japanese Orthopaedic Association(JOA)score for preoperative and postoperative scores.Results Patients were followed up 12-24months.The pain relieved in all patients.The JOA scores improved from(15.46 ±4.30)preoperatively to (24.50±1.58)postoperatively,the vertebral canal area of the affected segment was(218.4±16.2)mm2 before the operation,(264.6±9.9)mm2 after the operation.Single segment anterior disc space height did not change significantly,the difference was not statistically significant.The disc space posterior height increased compared with the preoperative height,and gradually decreased with time.No patients suffered Coflex loosening,fracture and emerge.Conclusion The treatment of lumbar spinal stenosis with Coflex system has satisfactory effect in minimal invasiveness and high security,which provides a safe and effective therapy for degenerative lumbar spinal stenosis.