Coflex棘突间固定装置在治疗腰椎管狭窄症中的价值

doi:10.13418/j.issn.1001-165x.2015.03.024

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (3): 344-348.doi: 10.13418/j.issn.1001-165x.2015.03.024

Coflex棘突间固定装置在治疗腰椎管狭窄症中的价值

郑晓青^1,2，　昌耘冰²，　李梦远²，　何宇翔²，　郑秋坚²

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

收稿日期:2014-12-11 出版日期:2015-05-25 发布日期:2015-07-24
通讯作者: 郑秋坚，主任医师，E-mail:zqj605@126.com
作者简介:并列第一作者：郑晓青（1981-），广东汕头人，主治医师，研究方向：脊柱伤病，Tel：13760818797，E-mail：zhengxiaoqing81@21cn.com 　　昌耘冰（1968-），杭州人，主任医师，研究方向：脊柱伤病，Tel：13808841600，E-mail：changyunbing@126.com

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

ZHENG Xiao-qing ^1,2, CHAN Yun-bing², LI Meng-yuan², HE Yu-xiang², ZHENG Qiu-jian²

1.Southern Medical University， Guangzhou 510515，China；2.Department of Orthopedics， Guangdong General Hospital & Guangdong Academy of Medical Sciences， Guangzhou 510080， China

Received:2014-12-11 Online:2015-05-25 Published:2015-07-24

摘要/Abstract

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。

关键词: , Coflex, 腰椎管狭窄症, 非融合技术, 邻近节段病变

Abstract:

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.

Key words: Coflex, Degenerative lumbar spinal stenosis, Non-fusion;adjacentsegment pathology

郑晓青,昌耘冰,李梦远,何宇翔,郑秋坚. Coflex棘突间固定装置在治疗腰椎管狭窄症中的价值[J]. 中国临床解剖学杂志, 2015, 33(3): 344-348.

参考文献

[1] Kreiner DS, Shaffer WO, Baisden JL, et al. An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update)[J]. Spine J, 2013, 13(7):734-743.
[2] Cheh G, Bridwell KH, Lenke LG, et al. Adjacent segment disease followinglumbar/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up[J]. Spine，2007, 32(20):2253-2257.
[3] Errico TJ, Kamerlink JR, Quirno M, et al. Survivorship of coflex Interlaminar-interspinous implant[J]. SAS Journal, 2009, 3(2):59-67.
[4] 海涌，周立金，苏庆军，等. 后路有限减压联合Coflex动态稳定术治疗腰椎管狭窄症的临床研究[J]. 中国骨与关节杂志, 2012, 1(1):11-16.
[5] Pfirrmann CW, Metzdorf A, Zanetti M, et al. Magnetic resonance classification of lumbar intervertebral disc degeneration[J]. Spine, 2001, 26(17):1873-1878.
[6] Weinstein JN, Tosteson TD, Lurie JD, et al. Surgical versus nonoperative treatment for lumbar spinal stenosis four-year results of the Spine Patient Outcomes Research Trial[J]. Spine, 2010, 35(14):1329-1338.
[7] Kabir SM, Gupta SR, Casey AT. Lumbar interspinous spacers: a systematic review of clinical and biomechanical evidence[J]. Spine, 2010, 35(25):E1499-E1506.
[8] Davis R, Auerbach JD, Bae H, et al. Can low-grade spondylolisthesis be effectively treated by either coflex interlaminar stabilization or laminectomy and posterior spinal fusion? Two-year clinical and radiographic results from the randomized, prospective, multicenter US investigational device exemption trial: clinical article[J]. J Neurosurg Spine, 2013, 19(2):174-184.

[9] 梁昌详，昌耘冰，沈梓维，等. 椎管减压棘突间Coflex置入术治疗L4/5退变性腰椎管狭窄症的5年随访结果[J]. 中国脊柱脊髓杂志, 2014，24(12):1072-1078. [10] Issack PS, Cunningham ME, Pumberger M, et al. Degenerative lumbar spinal stenosis: evaluation and management[J]. J Am Acad Orthop Surg, 2012, 20(8):527-535.
[11] Moojen WA, Arts MP, Jacobs WC, et al. Interspinous process device versus standard conventional surgical decompression for lumbar spinal stenosis: randomized controlled trial[J]. BMJ, 2013, 347:f6415.
[12] Wu AM, Zhou Y, Li QL, et al. Interspinous spacer versus traditional decompressive surgery for lumbar spinal stenosis: a systematic review and meta-analysis[J]. PLoS One, 2014, 9(5):e97142.
[13] Anderson PA, Andersson GB, Arnold PM, et al. Terminology[J]. Spine, 2012, 37(22 Suppl): S8-S9.
[14] Guyer RD, Mcafee PC, Banco RJ, et al. Prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: five-year follow-up[J]. Spine J,2009,9(5):374-386.
[15] Berg S, Tullberg T, Branth B, et al. Total disc replacement compared to lumbar fusion: a randomised controlled trial with 2-year follow-up[J]. Eur Spine J,2009,18(10):1512-1519.
[16] Goto K, Tajima N, Chosa E, et al. Effects of lumbar spinal fusion on the other lumbar intervertebral levels (three-dimensional finite element analysis)[J]. J Orthop Sci,2003,8(4):577-584.
[17] Chen CS, Cheng CK, Liu CL. A biomechanical comparison of posterolateral fusion and posterior fusion in the lumbar spine[J]. J Spinal Disord Tech,2002,15(1):53-63.
[18] Phillips FM, Reuben J, Wetzel F T. Intervertebral disc degeneration adjacent to a lumbar fusion. An experimental rabbit model[J]. J Bone Joint Surg Br,2002,84(2):289-294.
[19] Bono CM, Vaccaro AR. Interspinous process devices in the lumbar spine[J]. J Spinal Disord Tech, 2007, 20(3):255-261.

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 CoflexTM interspinous process device in the treatment of degenerative lumbar spinal stenosis

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