Coflex棘突间固定装置在治疗腰椎管狭窄症中的价值  

The application value of CoflexTMinterspinous process device in the treatment of degenerative lumbar spinal stenosis

作　　者：郑晓青[1,2] 昌耘冰[2] 李梦远[2] 何宇翔[2] 郑秋坚[2] 

机构地区：[1]南方医科大学,广州510515 [2]广东省人民医院广东省医学科学院骨科,广州510080

出　　处：《中国临床解剖学杂志》2015年第3期344-348,353,共6页Chinese Journal of Clinical Anatomy

摘　　要：目的评价Coflex棘突间固定装置治疗腰椎管狭窄症的应用价值。方法回顾性分析临床随访期>5年的手术治疗腰椎管狭窄症患者115例,其中Coflex组54例,融合组61例。比较两组围手术期指标及术前和末次随访时JOA、ODI、VAS、SF-36评分;比较两组术前及末次随访时邻近节段椎间活动度增加量、椎间隙高度丢失量及Pfirrmann分级评定。结果两组间临床观察指标无统计学差异(P>0.05)。两组椎间活动度增加量对比无统计学差异(P>0.05);融合组椎间隙高度丢失量较Coflex组明显(P<0.01);融合组相邻节段椎间盘Pfirrmann分级进展较Coflex组明显(P<0.05)。结论 Coflex植入术和融合术临床疗效相当,并能延缓影像学上的邻近节段病变。Objective To evaluate the application value of the Coflex interspinous process devicefor treatment of degenerative lumbar spinal stenosis. Methods 115 cases of degenerative lumbar spinal stenosis treated with surgery were retrospectively analyzed ,the followed-up period was more than 5 years. The coflex group have 54 cases, and the fusion group have 61 cases. The perioperative indicators were compared between the two groups. The JOA、VAS、ODl and SF-36 scores were compared between the two groups. The range of the increase of intervertebral motion, the loss of the intervertebral height and the Pfirrmann grade of the adjacent segments disc were measured at the pre-operative period and the final follow-up. Results The observational index had no statistical difference between the two groups （P〉0.05）. The range of increase of intervertebral motion of adjacent segments revealed no statistical difference （P〉 0.05）.The range of loss of intervertebral height of adjacent segments was greater in the fusion group, showing statistical difference （P〈0.01） between the two groups. The adjacent segment disc Pfirrmann grading progressed more obviously in the fusion group, demonstrating statistical difference （P〈 0.05） between the two groups. Conclusion The coflex implant and lumbar fusion have equivalent efficacy in the treatment of degenerative lumbar spinal stenosis, and the coflex implant can delay the adjacent segment pathology in radiology.

关 键 词：COFLEX 腰椎管狭窄症 非融合技术 邻近节段病变 

分 类 号：R681.5[医药卫生—骨科学]