Evaluation of Coflex interspinous stabilization following decompression compared with decompression and posterior lumbar interbody fusion for the treatment of lumbar degenerative disease: A minimum 5-year follow-up study.
Few studies have compared the clinical and radiological outcomes between Coflex interspinous stabilization and posterior lumbar interbody fusion (PLIF) for degenerative lumbar disease. We compared the at least 5-year clinical and radiological outcomes of Coflex stabilization and PLIF for lumbar degenerative disease. Eighty-seven consecutive patients with lumbar degenerative disease were retrospectively reviewed. Forty-two patients underwent decompression and Coflex interspinous stabilization (Coflex group), 45 patients underwent decompression and PLIF (PLIF group). Clinical and radiological outcomes were evaluated. Coflex subjects experienced less blood loss, shorter hospital stays and shorter operative time than PLIF (all p<0.001). Both groups demonstrated significant improvement in Oswestry Disability Index and visual analogue scale back and leg pain at each follow-up time point. The Coflex group had significantly better clinical outcomes during early follow-up. At final follow-up, the superior and inferior adjacent segments motion had no significant change in the Coflex group, while the superior adjacent segment motion increased significantly in the PLIF group. At final follow-up, the operative level motion was significantly decreased in both groups, but was greater in the Coflex group. The reoperation rate for adjacent segment disease was higher in the PLIF group, but this did not achieve statistical significance (11.1% vs. 4.8%, p=0.277). Both groups provided sustainable improved clinical outcomes for lumbar degenerative disease through at least 5-year follow-up. The Coflex group had significantly better early efficacy than the PLIF group. Coflex interspinous implantation after decompression is safe and effective for lumbar degenerative disease.
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, 8 Courtyard, Worker Palaestra South Road, Chao-Yang district, Beijing 100020, PR China.
Wei
W
Yuan
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, 8 Courtyard, Worker Palaestra South Road, Chao-Yang district, Beijing 100020, PR China.
Qing-Jun
QJ
Su
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, 8 Courtyard, Worker Palaestra South Road, Chao-Yang district, Beijing 100020, PR China.
Tie
T
Liu
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, 8 Courtyard, Worker Palaestra South Road, Chao-Yang district, Beijing 100020, PR China.
Jin-Cai
JC
Yang
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, 8 Courtyard, Worker Palaestra South Road, Chao-Yang district, Beijing 100020, PR China.
Nan
N
Kang
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, 8 Courtyard, Worker Palaestra South Road, Chao-Yang district, Beijing 100020, PR China.
Li
L
Guan
Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, 8 Courtyard, Worker Palaestra South Road, Chao-Yang district, Beijing 100020, PR China. Electronic address: spinesurgeon@163.com.
Yong
Y
Hai
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007902:Length of Stay / Q000639:trends; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000601:surgery*; D010147:Pain Measurement / Q000379:methods; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D016896:Treatment Outcome
Clinical outcome; Coflex interspinous stabilization; Long-term follow-up; Lumbar degenerative disease; Posterior lumbar interbody fusion