Abstract
Objective:To evaluate the long-term efficacy of the Coflex dynamic stabilization device in the treatment of lumbar disc herniation (LDH) versus simple discectomy.
Methods: We retrospectively analyzed 85 patients who underwent surgery for LDH between January 2009 and December 2013. Eligible patients with single-segment LDH were divided into two groups: discectomy with Coflex (Coflex group) and simple discectomy (SD group). The patient characteristics, surgical outcomes, operation time, blood loss, clinical and radiological features, complications, and reoperation rates were compared between both groups. In the Coflex group, the intervertebral height, intervertebral foramen height, and range of motion (ROM) of the treated segment were calculated from radiographs. Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were assessed for both groups before surgery, at 1 month, one year after surgery, and at final follow-up.
Results: The mean age, sex, body mass index (BMI), symptom duration, follow-up period, operated level, and Pfirrmann grade before surgery did not differ significantly between groups. The results showed significant improvements in the VAS and ODI scores in each group (P<0.05) after surgery. However, there were no significant differences in the VAS and ODI scores between both groups at 1 month or 1 year postoperatively. However, at the final follow-up, the VAS and ODI scores in the Coflex group were lower than those in the SD group(P<0.05). In the Coflex group, the anteriordisc height, posterior disc height, and intervertebral foramen height improved postoperatively. However, at the last follow-up, these values showed varying degrees of decline, returning to preoperative levels. In the flexion–extension radiographs, the ROM showed a significant decrease postoperatively, while the ROM continued to increase at the last follow-up (P<0.05). The mean operation time and blood loss were higher in the Coflex group than in the SD group(P<0.05). During the follow-up period, 3 patients (7.5%) in the Coflex group experienced complications, and 3 (7.5%) underwent secondary surgery. In the SD group, 1 patient (2.22%) experienced complications, and 5 (11.1%) underwent secondary surgery.
Conclusions This study revealed that the Coflex maintains the disc height of the surgical segment for a short period and preserves a limited ROM. Both Coflex and simple discectomies proved effective in treating LDH. However, long-term follow-up indicated that discectomy combined with Coflex produced superior clinical outcomes compared to simple discectomy, with fewer complications. Consequently, Coflex is a safe and effective treatment option for LDH.