Evaluation of Coflex interspinous stabilization following decompression compared with decompression and posterior lumbar interbody fusion for the treatment of lumbar degenerative disease: A minimum 5-year follow-up study |
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| Institution: | 1. The Ottawa Hospital, Department of Medicine, Division of Neurology, Ontario, Canada;2. The University of Ottawa, Ontario, Canada;3. The University of Sherbrooke, Québec, Canada;4. The Ottawa Hospital Research Institute, Ontario, Canada;5. The Ottawa Hospital, Diagnostic Imaging, Ontario, Canada;6. The Children’s Hospital of Eastern Ontario, Ontario, Canada;7. The Children’s Hospital of Eastern Ontario Research Institute, Ontario, Canada;1. Spine Institute of Louisiana, Shreveport, Louisiana, USA;2. The Spine Center, University of Colorado Hospital, Denver, Colorado, USA;3. Spine Colorado, Mercy Regional Hospital, Durango, Colorado, USA;4. Upstate Bone and Joint Center, East Syracuse, New York, USA;5. Private practice, San Francisco, California, USA;6. Private practice, Chicago, Illinois, USA;1. Orthopedic Surgery, Osaka National Hospital, Osaka, Japan;2. Orthopedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan;3. Orthopedic Surgery, Osaka Rosai Hospital, Osaka, Japan;1. Department for Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany;2. Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, Germany;3. Center for Spinal Surgery, Schön Klinik Düsseldorf SE & Co. KG, Düsseldorf, Germany;4. Department of Orthopaedic Surgery, Rhein-Maas Klinikum GmbH, Würselen, Germany;5. University of Cologne, Institute of Medical Statistics and Computational Biology, Cologne, Germany;1. Intensive Care Medicine Unit, Regional University Hospital of Malaga, Spain;2. Faculty of Medicine, University of Malaga, Spain |
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| Abstract: | Few studies have compared the clinical and radiological outcomes between Coflex interspinous stabilization and posterior lumbar interbody fusion (PLIF) for degenerative lumbar disease. We compared the at least 5-year clinical and radiological outcomes of Coflex stabilization and PLIF for lumbar degenerative disease. Eighty-seven consecutive patients with lumbar degenerative disease were retrospectively reviewed. Forty-two patients underwent decompression and Coflex interspinous stabilization (Coflex group), 45 patients underwent decompression and PLIF (PLIF group). Clinical and radiological outcomes were evaluated. Coflex subjects experienced less blood loss, shorter hospital stays and shorter operative time than PLIF (all p < 0.001). Both groups demonstrated significant improvement in Oswestry Disability Index and visual analogue scale back and leg pain at each follow-up time point. The Coflex group had significantly better clinical outcomes during early follow-up. At final follow-up, the superior and inferior adjacent segments motion had no significant change in the Coflex group, while the superior adjacent segment motion increased significantly in the PLIF group. At final follow-up, the operative level motion was significantly decreased in both groups, but was greater in the Coflex group. The reoperation rate for adjacent segment disease was higher in the PLIF group, but this did not achieve statistical significance (11.1% vs. 4.8%, p = 0.277). Both groups provided sustainable improved clinical outcomes for lumbar degenerative disease through at least 5-year follow-up. The Coflex group had significantly better early efficacy than the PLIF group. Coflex interspinous implantation after decompression is safe and effective for lumbar degenerative disease. |
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| Keywords: | Clinical outcome Coflex interspinous stabilization Long-term follow-up Lumbar degenerative disease Posterior lumbar interbody fusion |
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