Short-term clinical results of interspinous dynamic fixation of Coflex for the prevention of adjacent segment degeneration after lumbar fusion / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To observe the short-term clinical results of the adjacent segment degeneration after the implantation of Coflex system at the interspinous space of adjacent segment to lumbar fusion.</p><p><b>METHODS</b>Fifty patients with grade III disc (Thompson MRI classification) of adjacent segment to lumbar fusion were included and divided alternately into two groups according to the order of hospitalization from January to November 2009. Coflex system was implanted at the interspinous space of adjacent segment to lumbar fusion in 25 patients as Coflex group, the other 25 patients did not have any surgical treatment were as control group. The followed up time was 2 years. Visual analogue scale (VAS) score of low back pain, changes of disc height and motion range of adjacent segment to lumbar fusion on X-ray imaging were evaluated by independent sample t-test or paired samples t-test.</p><p><b>RESULTS</b>There were 22 patients in Coflex group and 21 patients in control group were followed up 2 years post-operation. The difference of VAS score between two groups was no significance (P > 0.05). In Coflex group, the change of postoperative disc height was no significance (P > 0.05), but the motion range was significantly reduced to 47% of the preoperative value (t = 7.99, P < 0.05). In control group, the postoperative disc height decreased slightly, without significant difference to the preoperative value (P > 0.05). Between the two groups, no differences of the disc height and motion range were found before operation, but the differences of the disc height changes (t = 6.7, P < 0.05) and motion rang (t = -14.5, P < 0.05) were significant in 2 years post-operation. No complications such as Coflex system loosen, immigration and spinal process fracture were occurred.</p><p><b>CONCLUSIONS</b>Coflex system can obviously limit the motion range and maintain the disc space height of adjacent segment to lumbar fusion, and prevent its degeneration in some degree.</p>