Result of 5-year follow-up of lumbar spinal decompression plus Coflex interlaminar placement for degenerative lumbar spinal stenosis

English Keywords:【Key words】 Degenerative lumbar stenosis  Coflex  Non-fusion technique  Posterior interbody fusion

English Abstract:

  【Abstract】 Objectives: To observe the clinical efficacy and safety of lumbar spinal decompression plus Coflex interlaminar placement for degenerative lumbar spinal stenosis. Methods: 103 patients undergoing surgery for degenerative lumbar spinal stenosis between April 2008 and May 2009 were followed up. 50 cases underwent coflex interlaminar placement with yellow ligament resection（coflex group）, while 53 patients were treated with laminectomy and lumbar interbody fusion(fusion group). The JOA, ODI and VAS scores were used to assess the clinical effects between two groups. The range of motion(ROM) and disc height of adjacent segments were measured pre-operatively and post-operatively. The outcome and safety were evaluated statistically. Results: The average follow-up for Coflex group was 5.43±0.21 years and 5.52±0.28 years for fusion group. There was no significant difference for JOA score, ODI score or VAS score between two groups at 2 years and 5 years of follow-up(P>0.05). There was no significant difference(P>0.05) for ROM or disc height of adjacent segments in Coflex group between pre-operation and 2 or 5-year post-operation. In fusion group, at 2 and 5 years after surgery, the ROM of upper disc significantly increased compared with that at pre-operation(P<0.05), and the ROM of lower disc also significantly increased at 5 years after surgery compared with that of pre-operation(P<0.05). In fusion group, at 2 and 5 years after surgery, ROM of upper and lower disc both increased compared with that in Coflex group(P<0.05). In fusion group, at 5 years after surgery, the upper disc height was lower than that at pre-operation(P<0.05), while higher than that in Coflex group(P<0.05). The rate of complication in Coflex group was 12%, while 9.4% in fusion group. The reoperation rate in Coflex group was 8%, and 5.6% in fusion group, which showed no statistical difference between two groups(P>0.05). The incidence of adjacent segment disease in fusion group was 13.2%, while 6% in Coflex group, which showed no statistical difference between two groups(P>0.05). Conclusions: The clinical outcome of Coflex implantation and traditional lumbar fusion is consistent. 5-year follow-up reveals the advantage of Coflex in maintaining the motion of adjacent level. However, its result needs long-term observation.