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Paradoxical Radiographic Changes of Coflex Interspinous Device with Minimum 2-Year Follow-Up in Lumbar Spinal Stenosis

 Nam Lee  ;  Dong Ah Shin  ;  Keung Nyun Kim  ;  Do Heum Yoon  ;  Yoon Ha  ;  Hyun Chul Shin  ;  Seong Yi 
 WORLD NEUROSURGERY, Vol.85 : 177-184, 2016 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Decompression, Surgical ; Equipment Design ; Equipment Failure Analysis ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc/diagnostic imaging ; Laminectomy ; Lumbar Vertebrae/diagnostic imaging* ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Postoperative Complications/diagnostic imaging* ; Prostheses and Implants* ; Radiography ; Range of Motion, Articular/physiology ; Spinal Stenosis/diagnostic imaging* ; Spinal Stenosis/surgery*
Coflex ; Disc height ; Erosion ; Lumbar spinal stenosis ; Range of motion
OBJECTIVES: Studies have yet to investigate long-term radiologic changes in lumbar spinal stenosis patients treated with interspinous device (Coflex). This study aimed to evaluate which radiologic parameters change significantly after surgery with Coflex and identify which parameter most affects the radiologic outcome. METHODS: Of 101 patients with lumbar spinal stenosis treated by Coflex insertion on L4-5, the radiologic parameters of 30 patients were measured before and at least 2 years after surgery. On the basis of the development of bony erosion around Coflex, patients were divided into the erosion group (n = 14) or the nonerosion group (n = 16). RESULTS: The mean anterior disc height (ADH) and range of motion (ROM) were significantly decreased after surgery (15.161 mm vs. 13.788 mm and 9.63° vs. 7.13°). The erosion group showed substantially higher values in preoperative ADH, postoperative posterior disc height (PDH), and intervertebral foramen height (6.52 mm vs. 8.05 mm; 5.80 mm vs. 8.03 mm; 19.20 mm vs. 21.06 mm). Postoperative ROM and ROM ratio were higher in the erosion group (5.95° vs. 8.47° and 0.659 vs. 0.938). However, only ADH showed a significant change in the erosion group after surgery (15.86 mm vs. 14.29 mm). On the contrary, ADH and PDH, as well as ROM, were significantly decreased in the nonerosion group (14.55 mm vs. 13.34 mm; 6.52 mm vs. 5.82 mm; 9.46° vs. 5.95°). CONCLUSION: The preoperative state including relatively higher ADH, PDH, and larger ROM could induce erosion. The long-term preservation of disc height and ROM may also induce erosion. That reduction of most radiologic parameters seems to be natural after surgery, and insufficient reduction of disc height and ROM may induce adverse effects, which can increase the possibility of spinous process fracture or device malposition.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Yoon, Do Heum(윤도흠) ORCID logo https://orcid.org/0000-0003-1452-5724
Yi, Seong(이성)
Ha, Yoon(하윤)
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