Abstract
Introduction The aim of the study is to compare the clinical outcomes of posterior decompression combined with interlaminar dynamic reconstruction-Coflex or transforaminal lumbar interbody fusion in treating lumbar disc herniation with instability. Materials and Methods A comparative study was performed on 13 male and 31 female patients (L3/4 18, L4/5 26) diagnosed as lumbar disc herniation with instability, with an average age of 53.6 years (range, 39-73 years), of which all cases were followed up at least 2 years. All patients were treated with interlaminar dynamic fixation with Coflex system (Coflex group, 19 cases) or transforaminal lumbar interbody fusion (TLIF group, 25 cases). The results were assessed by medical cost, operation time, blood loss, and Oswestry disability index (ODI). The range of motion (ROM) and intervertebral height of index and adjacent segments and the Lordosis of lumbar spine were measured before operation and last follow-up. Results The medical cost operative time and blood loss were significantly decreased in Coflex group than those in TLIF group. At the last follow-up, the ODI of groups Coflex and TLIF were significantly improved when compared with the preoperative values ( p < 0.05). At last follow-up, a better range of motion and intervertebral height of index and adjacent segments were found in Coflex group. However, the reoperation rate of Coflex group was higher than that of TLIF group ( p < 0.05). Conclusion Posterior decompression combined with Coflex has the same midterm effectiveness as transforaminal lumbar interbody fusion in treating degenerative lumbar disc herniation with instability and Coflex has less traumatic and recovery time, somewhat protective effect on the adjacent segments. However, the rate of reoperation is slightly higher in Coflex Group. Disclosure of Interest None declared
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