Treatment of degenerative diseases of the lumbar spine with COFLEX and DIAM dynamic interspinous implants

Abstract

Objective. To summarize own experience and to assess early results of surgical treatment of the lumbar spine degenerative disease using COFLEX and DIAM dynamic implants. Material and Methods. Dynamic interspinous fixation was performed in 96 patients at the age of 23 to 72 years. Pathologic substrate of clinical syndromes was intervertebral disc herniation and protrusion, osteophyte, degenerative spinal stenosis, and spinal segmental instability. In 88 cases interspinous fixation was combined with spinal root decompression, in other 8 cases the adjacent segment fixation was performed in the course of spinal fusion. Clinical and radiological results of the treatment were observed during 6 months after surgery. Results. Mean values of the Oswestry Disability Index in patients examined at 3 and 6 months postoperatively decreased till the level of minimal lesions. Interspinous fixation resulted in the intervertebral disc height increase in its posterior and, to a lesser degree, middle parts. Despite some decrease in segmental angle, there were no cases of kyphotic deformity. Flexion/extension mobility of the operated segment in a sagittal plane almost halved. The achieved correction of intersegment relations remained unchanged in 6 months after surgery. There were no complications associated with implant insertion. Radiological signs of bone tissue resorption in bone-implant interface were not observed. Reliable differences of the treatment results depending on the type of interspinous implant (COFLEX or DIAM) were not revealed. Conclusion. The studied technique is feasible, does not assume a distruction of any anatomical spine structures, and can be widely used not only for repair, but also for prevention of segmental instability.