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目的：评价Coflex棘突间固定装置治疗腰椎管狭窄症的应用价值。方法回顾性分析临床随访期＞5年的手术治疗腰椎管狭窄症患者115例，其中Coflex组54例，融合组61例。比较两组围手术期指标及术前和末次随访时JOA、ODI、VAS、SF-36评分；比较两组术前及末次随访时邻近节段椎间活动度增加量、椎间隙高度丢失量及Pfirrmann分级评定。结果两组间临床观察指标无统计学差异（P>0.05）。两组椎间活动度增加量对比无统计学差异（P>0.05）；融合组椎间隙高度丢失量较Coflex组明显（P 0.05).The range of loss of intervertebral height of adjacent segments was greater in the fusion group, showing statistical difference (P<0.01) between the two groups. The adjacent segment disc Pfirrmann grading progressed more obviously in the fusion group, demonstrating statistical difference (P< 0.05) between the two groups. Conclusion The coflex implant and lumbar fusion have equivalent efficacy in the treatment of degenerative lumbar spinal stenosis, and the coflex implant can delay the adjacent segment pathology in radiology.