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ZHOU Yang,XU Huazi,CHI Yonglong.Use of Coflex interspinous dynamic stabilization device for L5/S1 degenerative disease[J].Chinese Journal of Spine and Spinal Cord,2011,(8):627-632. |
Use of Coflex interspinous dynamic stabilization device for L5/S1 degenerative disease |
Received:July 05, 2011 Revised:July 07, 2011 |
English Keywords:Lumbar degenerative disease Nonfusion Interspinous dynamic stabilization device Coflex L5/S1 |
Fund:基金项目:国家自然科学基金(项目编号:30970702) |
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English Abstract: |
【Abstract】 Objective:To investigate the feasibility and clinical efficacy of Coflex interspinous dynamic stabilization device for L5/S1 degenerative disease.Method:Anatomic parameters of S1 interspinous process and Coflex prosthesis were measured in CT scan on 100 cases(50 males and 50 females) with normal adult sacrum.Then 46 cases with lumbar degenerative disease underwent Coflex implantation after laminectomy from November 2007 to February 2011.All cases were divided into two groups based on surgical levels(L4/5 and L5/S1).There were 25 L4/5,with an average age of 50.6 years(range,33 to 73 years) and an average follow-up of 25 months(range,17 to 39 months);L5/S1 group included 21 cases,with an average age of 48.8 years(range,34 to 65 years) and an average follow-up of 24 months(range,16 to 38 months).Visual analogue scale(VAS),Oswestry disability index(ODI),ventral intervertebral space height(VH),dorsal intervertebral space height(DH),intervertebral foramen height(IFH),the range of motion(ROM),Pfirmann classification of lumbar discs′ MRI signal were used to review the radiographic and clinical outcome.Result:The average length,width and depth of S1 spinous process for male was 20.48±5.82mm,14.94±3.56mm and 18.78±5.08mm respectively,while those for female was 18.81±3.45mm,11.58±2.95mm and 17.39±3.72mm respectively.Of these,70 cases had enough long S1 spinous process which could hold Coflex,while the S1 spinous process in the other 30 cases was so short that the prosthesis must be placed reversely.Coflex was placed in all cases of 2 groups.No serious complications were found in both groups.The ODI,VAS,VH,DH and IFH at final follow-up improved significantly(P<0.05).ROM of surgical level decreased(P<0.05),and ROM at caudal adjacent segment remained no change in both groups(P>0.05).No significant differences with respect to all parameters were noted in two groups(P>0.05).5 patients in L4/5 group had MRI grade of caudal adjacent disc increased 1 level,while 1 case in L5/S1 group had MRI grade of caudal adjacent disc increased 1 level.Conclusion:Coflex implantation after laminectomy for L5/S1 degenerative disease is feasible and effective. |
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