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Related Concept Videos

Herniated Intervertebral Disc l: Introduction01:29

Herniated Intervertebral Disc l: Introduction

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Intervertebral disc herniation refers to the displacement of the nucleus pulposus (the gel-like inner core of the disc) through a tear or weakened area in the annulus fibrosus (the outer fibrous ring). The displaced disc material extends beyond the normal boundaries of the disc space and may compress or irritate nearby spinal nerve roots or, less commonly, the spinal cord.Etiology and Risk FactorsHerniation commonly results from degeneration, in which aging reduces disc hydration and...
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Coflex Interspinous Stabilization with Decompression for Lumbar Spinal Stenosis: An Average 14-Year Follow-Up.

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The Coflex device for degenerative lumbar spinal stenosis (DLSS) preserves disc height but has a high reoperation rate, especially with spinal instability. Careful patient selection is crucial for optimal outcomes.

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Area of Science:

  • Spinal Surgery
  • Orthopedic Devices
  • Degenerative Lumbar Spinal Stenosis

Background:

  • Evaluates long-term clinical outcomes and radiologic changes of the Coflex device.
  • Focuses on patients with degenerative lumbar spinal stenosis (DLSS) treated with decompression and Coflex insertion.
  • Includes an average follow-up period of 14 years.

Purpose of the Study:

  • To assess the long-term clinical usefulness of the Coflex device after decompression for DLSS.
  • To analyze radiologic changes occurring around the Coflex device over time.
  • To identify factors influencing reoperation rates in patients treated with Coflex.

Main Methods:

  • Retrospective study of 147 patients with single-level DLSS.
  • Surgical treatment included decompression and Coflex insertion for patients unresponsive to conservative care.
  • Data collected on clinical scores, disc height, foramen height, and reoperation rates.

Main Results:

  • Significant reduction in Visual Analog Scale (VAS) pain scores postoperatively.
  • Minor decreases in intervertebral disc and foramen height observed.
  • Overall reoperation rate of 25%, with higher rates in patients exhibiting translational or angular instability.
  • Adjacent-segment reoperation rate was 10.8%.

Conclusions:

  • The Coflex device demonstrates long-term effectiveness in preserving disc and foramen height.
  • A significant reoperation rate is associated with Coflex use, particularly in unstable spines.
  • Careful patient selection is paramount to mitigate risks and optimize outcomes for DLSS treatment.