The average follow-up period was 7.12 ± 1.1 year in Coflex implantation group and 7.31 ± 1.6 year in fusion group, respectively. The average age was 57.6 ± 5.9 years old in Coflex implantation group and 59.0 ± 6.7 years old in fusion group, respectively. Adjacent segment degeneration at 元/4 and L5/Sl was assessed by Pfirrmann classification. The ranges of motion and the height loss at adjacent segments (元/4 and L5/S1) were measured preoperative and postoperative, respectively. The operation time, intraoperative blood loss, ambulation time, and hospitalization days, Japanese Orthopedic Association scores, visual analogue scale scores, Oswestry disability index and SF-36 scores were compared between the two groups. They were randomly and equally divided into two groups: 50 cases underwent spinal decompression with Coflex implantation, and 50 cases were treated with spinal decompression with fixation and fusion. Methods and findings: A total of 100 patients who were confirmed L4/5 lumbar spinal stenosis was surveyed from June 2007 to June 2010. The aim of the present study is to evaluate whether Coflex implantation following spinal decompression provided better clinical outcomes compared with traditional decompression and fusion for symptomatic lumbar spinal stenosis through midterm follow-up. High complication, reoperation rate, and costs with poor outcomes were also mentioned in the literature. However, controversy remains as to whether dynamic interspinous spacer use is superior to traditional decompression and fusion surgery. Background: Coflex, a kind of dynamic interspinous spacer, has been widely used for the treatment of lumbar spinal stenosis in the past a few years.
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