Lumbar spinal stenosis is a narrowing of the spinal cord that occurs in the lower part of the spine (lumbar region). For decades, surgical options for patients with lumbar spinal stenosis have been limited to decompression or decompression with spinal fusion. In 2012, the FDA approved the coflex® Interlaminar Stabilization® device, a small U-shaped titanium implant that provides spinal stability without invasiveness and loss of mobility associated with spinal fusion. Lumbar spinal stenosis is a condition that develops in the spinal canal of the lower back when the canal narrows, pressing on the spinal cord. This pressure can lead to pain, numbness, weakness and tingling in the back, legs and feet. While lumbar spinal stenosis can be a debilitating condition, it can be treated. For people suffering from moderate to severe spinal stenosis, surgery can be a great treatment option if non-surgical methods have failed.
Coflex surgery is one such option that can not only help relieve pain, but also keep the full range of motion in the spine, unlike traditional surgeries that may require fusion. Coflex surgery is a neurosurgical procedure that implants a titanium alloy device, known as the Coflex interlaminar stabilization device, in the back of the spine to relieve pain or numbness in the back, legs, or buttocks from spinal stenosis.
The Coflex device itself is a solid and flexible piece of U-shaped titanium alloy. The device is inserted between two adjacent lower dorsal bones immediately after surgical decompression of the affected vertebrae. The flexibility and power of the Coflex device allows it to support your spine without the need for spinal fusion, maintaining the full range of motion of your spine. This amazing device can be in five different sizes to meet the anatomical needs of the patient. The Coflex device is not for everyone.
Coflex Interlaminar Technology is an interlaminar stabilization device intended for use in one or two levels of L1-L5 lumbar stenosis in bone-matured patients with moderate impairment and who have undergone at least 6 months of non-surgical treatment. Interlaminar stabilization is performed after decompression of the stenosis at the affected levels.
Spine surgery is not something to rush for. Your doctor will first recommend that you try non-surgical treatment options, such as painkillers, physical therapy or steroid injections, before you are considered a candidate for Coflex surgery. If non-surgical options have not provided significant relief to your symptoms after six months, and the pain persists, then you may be considered for surgery. You will also need to have a confirmed diagnosis of spinal stenosis from a doctor to qualify for the coflex device. Most surgeons prefer patients over the age of 40, because you have certainly reached full skeletal maturity.
Other criteria that surgeons include:
- No previous lumbar fusions
- No pregnancy
- There is no lumbar disc herniation that requires simultaneous surgery
- Moderate to severe lumbar stenosis.
This procedure is a non-fusion, minimally invasive alternative to laminectomy with or without spinal fusion. Anesthesia is given and the patient is placed into position for operation. A small incision is made in the lower back. The goal of spinal stenosis surgery is to remove the bone or nerve elements that affect the nerves that are trying to expand to the rest of the body (called decompression). After the surgeon performs a direct decompression that removes bones, facets, ligaments, and / or discs from the narrowed spinal canal, your spine may become unstable. The Coflex device is then inserted directly after the decompression procedure to keep your spine stable while maintaining normal height and movement in the spine. The unique design of the coflex® device maintains stability in the spine after direct surgical decompression, while preserving more natural movement in the treated area. Like any open surgery, Coflex surgery carries some risks. Fortunately, the risks associated with Coflex surgery are usually rare. The greatest risk for patients with Coflex surgery is the possibility of constant pain. However, some other risks to consider before deciding on surgery are:
- Complications of wound healing
- Numbness or tingling in the arms or legs
- Spinous process fracture
If the device fails to relieve pain, you may need to undergo another operation to remove it. This is very rare, but can be reported if necessary.
The common question is how can Coflex surgery be compared to spinal fusion? One of the main advantages of Coflex surgery over spinal fusion is the preservation of movement. Often, with spinal fusion, the range of motion is lost in the treated and adjacent segments of the spine. However, Coflex surgery can preserve a significant range of motion in the treated area. But this is not the only advantage Coflex surgery offers over spinal fusion. In clinical studies comparing Coflex surgery with spinal fusion, patients receiving Coflex surgery experienced:
- Immediate relief of back and leg pain
- Less blood loss
- Less hospital days
- Faster recovery time
Immediately after surgery
When you wake up after recovery, you may be able to get up and walk almost immediately, taking into account your overall health at the time of surgery. Since there is no fusion, and therefore no bone healing to wait, you will most likely be able to do so immediately after the procedure. You will notice that your pain is significantly relieved, and your spine should feel stable and strong. Most patients have to wait a few days after the operation for the wound on their back to heal. A few weeks and months after surgery, in the weeks and months after surgery, your recovery depends on a number of factors, including the degree of stenosis and the degree of decompression that has been performed. Most patients can return to normal activities, and even extended activities, such as cycling and other activities, within a few weeks after surgery. Some patients may need physical therapy to improve mobility and flexibility. Every patient is different; therefore, the results may vary.