关键词:  腰椎融合术, 非融合手术, Coflex, 邻近节段退变

Abstract:

Objective　To compare the clinical effectiveness and adjacent segment degeneration of posterior decompression combined with Coflex interspinous dynamic reconstruction or lumbar intervertebral fusion for degenerative lumbar spinal disorders.　Methods　The patients with the age ranging from 40 to 60 that received the coflex implantation and lumbar intervertebral fusion at L4/5 were retrospectively investigated from May, 2008 to May, 2010.There were 48 cases in group coflex with an average age of 48.7 and an average follow-up of 34.6 months. There were 52 cases in group fusion with an average age of 49.5 and an average follow-up of 37.4 months. Compare the difference in surgical duration, blood loss and hospitalization length between two groups. The JOA score, VAS score and ODI score were preoperatively compared and postoperatively compared at follow-up. The range of motion (ROM) and intervertebral height of affected adjacent segments were measured before operation and last follow-up.　Results　There were not statistical differences at JOA score, ODI score and VAS score between two groups prior to surgery and at last follow-up. Compared with the fusion group, the Coflex group had shorter surgical duration, less blood loss and shorter hospitalization length. Patients in the fusion group had a larger range of motion at adjacent segments. There was no statistic difference in the intervertebral height between pre- and post-operation in both groups. 　Conclusions  Treating degenerative lumbar spinal disorders on people with age between 40-60 can achieve good clinical results by the use of Both Coflex interspinous dynamic reconstruction and lumbar intervertebral fusion. However, using the coflex implantation have shorter surgical duration and quicker recover, which can also protect the adjacent segments effectively.

Key words: Coflex, Lumber fusion, Dynamic stabilization, Adjacent segment degeneration