Abstract

To evaluate the clinical efficacy of coflex interspinous implant for bisegmental lumbar spinal stenosis, 23 cases of bisegmental lumbar spinal stenosis were treated with coflex interspinous implant for lumbar fusion (Coflex plus fusion, n =12), or bisegmental posterior lumbar interbody fusion (bisegmental fusion, n = 11). The operation time, bleeding volume, and the visual analog scale (VAS) for lumbar pain, the VAS for leg pain, the Oswestry Disability Index (ODI), and the range of motion (ROM) for the upper and lower surgical segments and upper adjacent segment prior to operation and at the last follow up within or between two groups were compared. The bleeding volume was less in the coflex plus fusion group than in the bisegmental fusion (P = 0.03). The ROM for the upper surgical segments was smaller at the last follow up than prior to operation in two groups (P = 0.04; P<0.01). No statistically significant difference was noted in the ROM for the upper surgical segments between two groups prior to operation (P = 0.79), while it was statistically significantly higher in the coflex plus fusion group than the bisegemental fusion group (P<0.01). There was no statistically significant difference in the ROM for the upper adjacent segments between two groups prior to operation (P = 0.02), while it was significantly higher in the bisegmental fusion group than in the coflex plus fusion group at the last follow up (P<0.01). The Coflex interspinous implant for lumbar fusion achieves similar efficacy with bisegmental posterior lumbar interbody fusion in clinical practice. But it causes less bleeding, retains intervertebral activity for surgical segments, and effectively reduces the intervertebral space activity for the upper adjacent segments.

Key words: Bisegment, lumbar spinal stenosis, coflex, posterior lumbar interbody fusion.