Coflex 棘突间固定系统治疗腰椎管狭窄症的临床疗效评价

摘要

Objective To evaluate the effectiveness of lumbar spinal stenosis by Coflex.Methods A total of 36 patients treated by Coflex from April 2010 to April 2012 in our hospital were retro-spectively analyzed.The period of follow-up was 2 year.Clinical effect was evaluated by VAS pain in low back and lower limb,JOA score,and Prolo functional score.In order to estimate the lumbar movement and the degeneration of the contiguous hernation,the operation segment movement degree and the height of contiguous hernation were assessed by lumbar X ray.Results The VAS score and JOA score of post-operative were higher than pre-operative.The post-op-erative Prolo functional score was lower than pre-operative.There were no significant difference among the post-operative follow up.The Cobb angle in lateral projection,bending projection be-tween pre-operative and post-operative were different.The height of contiguous hernation be-tween pre-operative and post-operative had no significant difference.Conclusion Coflex is a min-i-invasion fixation of spine,and could relieve the pain of the low back and lower limbs,improve the quality of life,reduce the time of operation and hospitalization.And the Coflex could restore spinal mobility and relieve the regeneration of the contiguous hernation.Moreover,the Coflex had a good safety and lower complication.%目的：对 Coflex 棘突间固定系统在治疗腰椎管狭窄症中的应用进行疗效分析。方法回顾性分析2010年4月至2012年4月采用 Coflex 棘突间固定系统治疗腰椎管狭窄的患者36例，随访时间2年。通过腰痛 VAS 评分、下肢痛 VAS 评分、腰椎 JOA 评分、Prolo 评分来评价其临床疗效，通过影像学中手术阶段前凸角及手术相邻阶段椎间盘的高度的测量分析其对手术阶段的稳定性和活动度及相邻阶段椎间盘退变的影响。结果术前及术后各随访时间点患者的腰痛评分、下肢痛评分、JOA 评分及 Prolo 功能评分的结果相比差异有统计学意义，但术后各时间点数据分析差异并无统计学意义。影像学测量所得前凸角在术前及术后各时间点相比差异无统计学意义。相邻阶段椎间隙高度变化在术前及术后各个随访时间点差异无统计学意义。结论Coflex 棘突间固定可有效地缓解因椎管狭窄造成的腰部及下肢痛，提高患者的生活质量，减少患者手术及住院时间。在保留脊柱活动度及降低邻近阶段椎间盘退变方面效果良好，有较好的安全性，且并发症少。