What Is Coflex?

• In simple terms: Coflex is a small, titanium U-shaped device placed between the bones in your lower back after decompression. It holds the space open for nerves and stabilizes the spine without fusion.
  
  

• Scientifically: The Coflex device is an interlaminar dynamic stabilizer implanted after lumbar decompression. It resists extension, maintains foraminal and canal dimensions, and redistributes load, providing stability while preserving sagittal motion at the treated level.
  
  

Conditions Treated

• Lumbar spinal stenosis causing neurogenic claudication
  
  

• Back and leg pain relieved by flexion (classic “shopping cart sign”)
  
  

• Patients who fail conservative care (PT, medications, injections)
  
  

• Single- or two-level stenosis (typically L1–L5) without instability requiring fusion
  
  

Who Is a Candidate?

Good candidates:

• Moderate lumbar stenosis confirmed on MRI/CT
  
  

• No significant spondylolisthesis (>Grade 1)
  
  

• Desire to avoid spinal fusion if possible
  
  

• Intact spinous processes
  
  

Not candidates if:

• Significant instability, deformity, or high-grade spondylolisthesis
  
  

• Severe osteoporosis or prior laminectomy with spinous process removal
  
  

• Multi-level disease beyond two levels
  
  

The Coflex Procedure: Step by Step

Plain-English Overview

1. Anesthesia & positioning: You’re asleep under general anesthesia, lying face down.
   
   

2. Lumbar decompression: The lamina and ligamentum flavum are trimmed to relieve nerve pressure.
   
   

3. Implant placement: A small titanium U-shaped device (Coflex) is placed between spinous processes at the treated level.
   
   

4. Stabilization: The device locks in place, supporting the decompressed area while preserving motion.
   
   

5. Closure: The incision is closed; many patients go home the same day or next.
   
   

Surgeon-Level Detail

• Exposure: Posterior midline or paramedian incision, tubular retractor system possible.
  
  

• Decompression: Laminotomy/laminectomy ± medial facetectomy to free neural elements.
  
  

• Sizing: Interspinous space sized using templates; implant chosen accordingly.
  
  

• Implant insertion: Coflex device impacted between spinous processes; wings expanded to secure position.
  
  

• Final check: Fluoroscopy verifies placement; device resists extension but allows flexion.
  
  

• Closure: Layered closure; sterile dressing applied.
  
  

Benefits of Coflex Placement

• Provides stability without fusion
  
  

• Preserves motion at the treated level
  
  

• Faster recovery compared to fusion
  
  

• Reliable relief of leg pain and neurogenic claudication
  
  

• Less stress on adjacent levels compared to fusion
  
  

Risks & Limitations

• Device migration or loosening (rare with correct sizing)
  
  

• Spinous process fracture (uncommon)
  
  

• Infection, bleeding, or dural tear (as with any decompression)
  
  

• Not appropriate for patients with instability, deformity, or osteoporosis
  
  

• May still require conversion to fusion in the future if degeneration progresses
  
  

Recovery Timeline

• Day 0–1: Walking the same day; many go home within 24 hours
  
  

• Weeks 1–2: Light activities, incision care, frequent short walks
  
  

• Weeks 2–6: Desk work and driving usually resumed
  
  

• 6–12 weeks: Structured physical therapy; progressive return to activity
  
  

• 3–6 months: Strong symptom relief; most activities restored
  
  

• 12 months: X-rays confirm ongoing stability and motion preservation
  
  

Why Choose Desert Spine and Pain?

• Expert neurosurgeon: Dr. Greenwald is highly experienced in both decompression and motion-preserving procedures like Coflex
  
  

• Personalized care: Careful patient selection ensures the best outcomes
  
  

• Minimally invasive focus: Small incisions and precision tools for quicker recovery
  
  

• Full-spectrum options: From decompression alone to Coflex to fusion, all tailored to your needs
  
  

Frequently Asked Questions

How is Coflex different from spinal fusion?

Fusion eliminates motion at the treated level. Coflex preserves motion while providing stability after decompression.

Will Coflex cure my back pain?

It is best for patients whose primary issue is leg pain and walking intolerance from stenosis. Back pain relief is variable.

Can the device move or break?

Device migration is rare when placed correctly. We use meticulous technique and proper sizing to minimize this risk.

How soon can I return to normal activity?

Many patients resume light activities within 2–6 weeks, with full recovery by 3–6 months.

How does Desert Spine and Pain approach Coflex differently?

We emphasize evidence-based patient selection, advanced MIS decompression, and long-term monitoring to maximize safety and effectiveness.