Coflex装置防治腰椎退行性疾患的短期疗效分析

目的总结Coflex棘突间稳定装置治疗腰椎退行性疾患的短期疗效。方法对本组2008年以来应用Coflex手术治疗的18例患者的临床资料进行回顾性总结分析。男性10例，女性8例，年龄44～65岁，平均为50．2岁。行微创减压＋Coflex植入者14例，行椎间融合内固定＋融合节段上方Coflex植入术者4例。其中L3-4节段6例，L4-5节段12例。术后应用Oswestry功能障碍指数（oswestry disability index，ODI）、视觉模拟（visual analogue pain score，VAS）评分及影像学检查对临床疗效进行评价。所有患者均行随访，平均随访时间12个月。结果手术时间80～190min，平均120．5min。术后椎间隙高度得到恢复，末次随访高度未见明显丢失。VAS评分由术前的（7．9±1．1）分减至末次随访的（2．6±0．7）分，ODI由术前的（58．2±9．6）％减至末次随访的（26．8±3．4）％。在随访期间VAS评分及ODI均得到明显恢复，与术前相比均有显著性差异（P〈0．001）。结论腰椎退行性疾患微创减压术后植入Coflex棘突间稳定装置，在腰痛、神经源性跛行以及患者满意度上显示出了良好的效果。

Early Clinical Observation of Coflex-an Interspious Stabilization in the Surgical Treatment of Lumbar Degenerative Disease

Objective To summarize the early experience of the implantation of Coflex interspious stabilization device for the treatment of early lumbar degenerative disease. Methods The clinic data of 18 patients from 2008 of the implantation of Coflex device were reviewed and analyzed. There were 10 males and 8 females. The average age of the patients was 50. 2 years（range 44-65 years）. 14 patients were used alone Coflex device after microsurgical decom pression,and 4 patients were associated with another type of material above the arthrodesis;6 cases L3-4 intervertebral space,and 12 cases L3-4 intervertebral space. A score of VAS and the Oswestry Disability Index were used to assess clinical outcome. Disc height and bone union were examined. All cases were followed up for 12 months. Results The operating time varied between 80 and 190 minutes ,mean 120.5 minutes. Disc space height was restored by the surgery and maintained at the latest follow up time. Clinically,the pain index and Oswestry score improved significantly from before surgery to the latest follow up. The pain index reduced from 7.9 to 2.6（P〈0.001）. The postoperative ODI showed a significant postoperative reduction of disability during the whole period of follow-up （P〈Q0. 001）. Preoperative mean Oswestry score was 58.2,and postoperative 26.8. Conclusion Coflex interspinous stabilization device after microsurgical decompression for spinal stenosis demonstrates excellent results for improvement in back pain,neurogenic claudication and patient satisfaction.