Experience in the use of dynamic interspinous fixation in the treatment of lumbar spine stenosis

The results of surgical treatment of lumbar stenosis using the dynamic intercostal fixator Coflex in the period from September 2016 to February 2019 were analyzed in 36 patients, 25 of them with monosegmental stenosis, 11 with two levels. Caudogenic intermittent claudication was observed in 27 patients. Dynamic interspinous fixation was performed on38 vertebral-motor segments of the lumbar. Assessment of the quality of life and the intensity of pain in the back and leg before and after the operation, as well as the outcome of the operation in the distant period after the operation, was carried out by validated scales and questionnaires. There were no intraoperative complications. In the distant period after surgery, the results of control functional spondylography of the lumbar revealed a direct dependence of the mobility of the operated vertebral-motor segment on the value of the disk height index. In all observations, a decrease in the mobility of the operated level was noted, which indicated the high-quality functioning of the interspinous implant. An increase in the height of the intervertebral foramen additionally provided indirect decompression of the spinal nerve in all cases. Syndrome of caudogenic intermittent claudication by the time of discharge regressed in all cases. For the period of observation of cases of development of postoperative instability and restenosis at the operated level was not noted. Satisfactory outcomes were obtained in 33 (91,7%), and unsatisfactory outcomes in 3 (8,3%) cases. Unsatisfactory outcomes in two cases were due to chronic pain in the lower back due to symptomatic stenosis of the spinal canal at an adjacent level, and in one observation, severe pain in the right leg due to the formation of sequestered herniated discs at an adjacent level. In general, interspinous dynamic stabilization has proven itself in the treatment of spinal stenosis of the lumbar spine, as the completion of the operation after the decompression phase.