Analysis of Coflex Interspinous Dynamic Stabilization System for Treatment of Lumbar Degenerative Disc Disease： Minimal 10 Years Follow-up
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0614
- VernacularTitle:Coflex棘突间动态稳定系统治疗腰椎间盘退行性疾病10年随访情况分析
- Author:
Hong-lin GU
1
;
Xiao-qing ZHENG
1
;
Chang-xiang LIANG
1
;
Shi-xing ZENG
1
;
Shi-qiang ZHAN
1
;
Yun-bing CHANG
1
Author Information
1. Spine Department， Guangdong Provincial People's Hospital//Guangdong Academy of Medical Sciences， Guangzhou 510080， China
- Publication Type:Journal Article
- Keywords:
interspinous dynamic stabilization system;
Coflex;
lumbar disc degenerative disease;
survivorship;
reoperation
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(6):913-922
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe aim of the present retrospective study was to access the long-term efficacy， complication rate， reoperation rate and survival rate of Coflex interspinous process dynamic stabilization system in the treatment of lumbar degenerative disc disease， and investigate the influencing factors of implant survivorship and reoperation. MethodsTotally 109 patients with lumbar disc degenerative disease who underwent posterior decompression or discectomy + Coflex fixation in Guangdong Provincial People's Hospital from May 2008 to June 2011 followed up for minimal 10 years were selected. Preoperative and postoperative Japanese Orthopedic Association （JOA） score， Oswestry Disability Index （ODI）， visual analogue scale （VAS） score were collected.And complications， reoperation， and device survival rate of patients with different diagnoses were evaluated. ResultsOf the 109 patients， 74 cases were male and 35 cases were female， average 45.55±11.83， M （P25～P75） ［45 （38～52）］ years. 28 cases were lumbar disc herniation， 16 cases were diagnosed as lumbar stenosis， 61 cases were lumbar stenosis combined with lumbar disc herniation， and 4 cases were spondylolisthesis. The mean follow-up time was 133.37±11.68 （120-157）， M （P25～P75） ［130 （123～142）］ months. VAS， JOA and ODI scores at last follow-up had significantly improved compared to pre-operation （P < 0.05）. Overall complication rate was 12.8% （14/109）， the reoperation rate was 9.2% （10/109） and the 5-year and 10-year survival rates were 95.4% （104/109）. Compared with patients of other diagnoses， patients with lumbar disc herniation had the highest rate of complication （21.4%， 6/28） and reoperation rate （14.3%， 4/28）， and the lowest 5-year and 10-year survival rates （92.9%， 26/28）. Patients with spondylolisthesis who had Coflex placed at the adjacent segment as Topping-off had no complications or reoperation， and the survival rate was 100%. ConclusionsCoflex implantation can achieve satisfactory long-term survival rate and clinical outcomes in the treatment of lumbar disc degenerative diseases. The risk of complication， reoperation and implant removal may be related to indications. It should be performed with caution in patients with lumbar disc herniation， but may be indicated in one to two level mild-to-moderate lumbar stenosis and Topping-off with considerable high safety.
