Coflex棘突间撑开装置与后外侧植骨融合治疗腰椎退变性疾病的对比分析

Contrast Analysis of Coflex Interspinous Distraction Device and Posterolateral Fusion in Treatment of Lumbar Degenerative Disease

目的比较单节段Coflex棘突间撑开装置与后路后外侧融合内固定治疗L4／5退变性疾病的短期临床疗效。方法对2009年11月-2011年9月采用后路椎板开窗减压联合c6flex棘突间撑开装置（A组，25例）治疗与后路后外侧植骨融合钉棒内固定术（B组，30例）治疗L4／5退、变性疾病进行前瞻性对照研究。两组般资料差异无统计学意义（P〉0．05）。术前及末次随访时对患者行腰椎JOA评分、VAs评分、Oswestry功能障篇指数（ODI）及影像学分析评价其疗效。结果末次随访时A＇B组JOA评分、VAS及ODI评分均优于术前（P〈0．05），差异具有统计学意义。A组末次随访手术节段ROM较B组大，A组末次随访手术上邻节段ROM较B组小，差异均有统计学意义。结论两组治疗L4／5退变性疾病疗效显著且相当，但Coflex组对维持脊柱单元运动稳定性具有积极作用，对邻近节段具有保护作用。

Objective To compare the short-term clinical effect of single segment Coflex interspinous distraction device and the posterior lateral fusion and internal fixation for the treatment of degenerative disease of IA/5. Methods Prospectively controlled study were carried from November 2009 to September 2011 by posterior fenestration decompression combined with Coflex interspinous distraction device（ group A,25 cases） and posterolateral fusion screw- rod fixation（ group B,30 cases} for the treatment of degenerative disease of IA/5. Baseline data in two groups had no significant difference（ P 〉 0.05 ）. Preoperative and last follow-up of lumbar JOA score, VAS score, Oswestry disability index（ODl） and imaging analysis of patients were evaluated as curative effect. Results The last follow-up of JOA score, VAS and ODI scores in both groups were better than preoperative （ P 〈 0.05 ） , the difference was statistically sig- nificant. Group A of last fbllow-up operation section ROM compared with group B,group A at the last follow-up operation on the adjacent segment of ROM compared with group B,there were significant differences. Conclusion Curative effect of IA/5 degenerative diseases in two groups is distinct and ahnost the same,but there is positive effect to maintain spinal unit movement stability and protective effect on the adjacent segments in Coflex group.