Abstract:Objective: To compare and analyze the short-term effects and follow-up results of Coflex system implantation and full laminectomy bone grafting fusion internal fixation (fusion technique) for elderly lumbar spinal stenosis (LSS). Methods: 72 elderly patients with LSS in our hospital were selected as the research subjects, and they were randomly divided into the control group and the observation group, whit 36 cases in each group. The control group was treated with fusion technique, and the observation group was implanted with Coflex system implantation. The operation condition, nerve function, pain improvement, postoperative complications and imaging indexes of the two groups were observed. Results:The operation time, intraoperative bleeding volume, the flow rate of wound and the hospitalization time in the observation group were significantly lower than those in the control group (P<0.05). The VAS scores of both groups decreased significantly at 3 months after operation (P<0.05). The JOA scores of the two groups increased significantly 6 months and 2 years after operation (P<0.05), and the change level of the observation group was significantly higher than that of the control group (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Two years after operation, there was no significant difference in the height of adjacent intervertebral space between the two groups (P>0.05). The activity of adjacent intervertebral space in the control group increased significantly (P<0.05). There was no significant change in the observation group (P>0.05). The activity of adjacent intervertebral space in the observation group was significantly lower than that in the control group (P<0.05). Conclusion:Coflex system implantation is an ideal short-term treatment for senile LSS. Two years follow-up shows that it can avoid the increase of adjacent segment intervertebral mobility to a certain extent, which is worthy of clinical application.
潘复建, 段毅. Coflex系统植入术与融合技术治疗老年腰椎管狭窄症疗效观察[J]. 河北医学, 2019, 25(2): 288-291.
PAN Fujian, DUAN Yi. Curative Effects Observation of Coflex System Implantation and Fusion Technique in the Treatment of Elderly Lumbar Spinal Stenosis. HeBei Med, 2019, 25(2): 288-291.
[1] 方秀统,李洋,付胜良,等.老年人腰椎管狭窄症的临床特点及手术治疗[J].中国老年学,2015,35(22):6487~6488. [2] 于海波.改良腰椎后路椎间融合术与传统PLIF治疗老年腰椎管狭窄症的临床疗效分析[J].中国医药导刊,2016,18(1):9~10. [3] 郑晓青,昌耘冰,李梦远,等.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. [4] Shirado O, Doi T, Akai M, et al. An outcome measure for Japanese people with chronic low back pain: an introduction and validation study of japan low back pain evaluation questionnaire.[J]. Spine,2007,32(26):3052~3059. [5] 李仲廉.临床疼痛治疗学[M].第3版.天津:科学技术出版社,2003.378~382. [6] 余磊,梁宏伟,孙冶智,等.椎间孔镜选择性减压治疗老年腰椎管狭窄症疗效观察[J].山东医药,2017,57(23):86~88. [7] 潘爱星,海涌,杨晋才,等.棘突间Coflex动态内固定系统治疗腰椎退行性疾病的影像学研究[J].中华外科杂志,2016,54(7):513~517. [8] Yaghoubi M, Moradi-Lakeh M, Moradi-Joo M, et al. The cost effectiveness of dynamic and static interspinous spacer for lumbar spinal stenosis compared with laminectomy[J]. MJIRI,2016,30(1):339. [9] Kamal T T, ElNikety S, James O, et al. Reported clinical outcomes of coflex dynamic stabilization device Vs instrumented decompression and fusion in degenerative lumbar stenosis[J]. MOJ Orthop Rheumatol,2016,5(6):200~204. [10] 杨兆义,王庆雷,马建华,等.老年退行性腰椎管狭窄症的椎板间开窗减压与全椎板减压手术治疗及分析[J].中国药物与临床,2016,16(9):1321~1322.