Coflex Surgery

What is Coflex Surgery?

Coflex surgery refers to a neurological procedure that implants a U-shaped, titanium alloy device, known as the “Coflex Interlaminar Stabilization Device”, in the lower back of the patient’s spine. The device successfully implants between the two adjacent spinal bones immediately after the surgical relief of pressure on the spinal nerves. Coflex system effectively helps to relieve the pain associated with lumbar spinal stenosis ¹.

Lumbar spinal stenosis forms a narrowing passage for the spinal cord and nerves that continuously gives compression to the associated nerve roots. Neurosurgeons perform a direct decompression surgery to remove the bones, facet, or segment of a disc from the narrowed spinal canal that makes the spine become unstable. To stable the spine, surgeons insert the Coflex device in between the spinal bones to maintain the motion of your spine and ease the symptoms of spinal stenosis.

Coflex device helps to support your spine without the need for spinal fusion. The size of this device may vary according to the different anatomical structures of the patient. To date, this device comes into five different sizes to match the needs of an individual patient’s anatomy. The benefit of Coflex surgery may include ²:

1. Improving the normal range of motion and making the spinal cord stable.
2. Quick relief of pain in the leg, back, and buttocks due to stenosis.
3. Best alternative of traditional spinal fusion.

What type of patients might benefit from Coflex Surgery?

In general, spinal stenosis affects 8% to 11% of adults over 65 years old ³. The spinal degeneration along with the pressure on the nerve roots commonly seen after 50 years of age in both men and women. You may need Coflex surgery if you suffer from long-term spinal stenosis with pain in the lumbar area.

Before considering you as a candidate for the Coflex surgery, your doctor will try other non-surgical treatment protocols, such as pain medications, physical therapy, or steroid injections. If the symptoms persist after six months of conservative treatment, your doctor will go for Coflex surgery. The criteria to be an appropriate candidate for Coflex surgery may include ⁴:

• Skeletally matured people of at least 40 years of age or older.
• Non-pregnant women.
• No prior spinal fusion.
• Performed ineffective nonsurgical treatment for at least 6 months.

How do neurosurgeons perform Coflex Surge?

The Coflex surgery requires a well-trained neurosurgeon, a neurologist, an anesthesiologist, and an assistant to perform successfully. The surgery to implant the Coflex device requires at least 1 to 2 hours. The process includes:

1. You need to lie on your stomach in the operation table with pillows supporting each side of the body.
2. Surgeon will perform general anesthesia to make the patient sleep so that the patient will not feel any pain or sensation.
3. Surgeons will give a small incision in the lower back.
4. Your surgeon will split the back muscles and ligament to create a path towards the rear of the spine.
5. Surgeons will access the spinous process and remove the bony overgrowth, bone spurs, and disc nucleus. A small portion of one or more lamina needs to resurface to make the device fit in the area.
6. By using fluoroscopic guidance, your surgeon will implant the Coflex device through the incision and placed between the spinous processes.
7. Finally, surgeons will suture the skin together after putting back the muscles and other tissues in place.

Research shows that about 90% of patients get relief from pain within 6 weeks of Coflex surgery. Coflex surgery requires 36% less time than spinal fusion, and approximately 94% of the patient shows their satisfaction with the outcome of their Coflex surgery ⁵. General post-operative complications of this surgery include infection, blood loss, numbness of arms and legs, etc. Coflex surgery requires about 4 to 6 weeks for a complete recovery. A regular course of antibiotics will prevent any post-surgical infections in the surgical site. Talk to your surgeon in case of any post-surgical abnormalities.

References

1. Zhang JX, Jing XW, Cui P, He X, Hao DJ, Li SJ. Effectiveness of dynamic fixation coflex treatment for degenerative lumbar spinal stenosis. Experimental and Therapeutic Medicine. 2018;15(1):667–672. doi:10.3892/etm.2017.5508
2. Richter A, Schütz C, Hauck M, Halm H. Does an interspinous device (Coflex^TM) improve the outcome of decompressive surgery in lumbar spinal stenosis? One-year follow up of a prospective case control study of 60 patients. European Spine Journal. 2010;19(2):283–289. doi:10.1007/s00586-009-1229-9
3. Schmier JK, Halevi M, Maislin G, Ong K. Comparative cost effectiveness of Coflex® interlaminar stabilization versus instrumented posterolateral lumbar fusion for the treatment of lumbar spinal stenosis and spondylolisthesis. ClinicoEconomics and Outcomes Research. 2014;6(1):125–131. doi:10.2147/CEOR.S59194
4. Davis RJ, Errico TJ, Bae H, Auerbach JD. Decompression and coflex interlaminar stabilization compared with decompression and instrumented spinal fusion for spinal stenosis and low-grade degenerative spondylolisthesis: Two-year results from the prospective, randomized, multicenter, food and drug administration investigational device exemption trial. Spine. 2013;38(18):1529–1539. doi:10.1097/BRS.0b013e31829a6d0a
5. Li A min, Li X, Yang Z. Decompression and coflex interlaminar stabilisation compared with conventional surgical procedures for lumbar spinal stenosis: A systematic review and meta-analysis. International Journal of Surgery. 2017;40:60–67. http://dx.doi.org/10.1016/j.ijsu.2017.02.056. doi:10.1016/j.ijsu.2017.02.056