Use of the Coflex implant for spinal stenosis treatment can help some patients to improve procedural outcomes following decompression surgery. It is crucial to understand the Coflex does not directly treat stenosis of any kind, nor will it do anything to relieve the symptoms of spinal stenosis. Instead, Coflex is designed as a complement to surgical canal decompression that allows the patient additional options for stabilization of the vertebral column after resolution of the canal impingement.
Patients write to us often asking about the best path towards successful surgical treatment for lumbar spinal stenosis. There are more options now than ever before and many patients get confused by these many variations of operative intervention. In order to make a decision if a spinal implant such as Coflex or X-Stop is right for your particular needs, it is absolutely crucial to understand how they work, when they are indicated and what benefits might they confer.
This patient guide examines the surgical application of the Coflex spinal implant for use in lumbar stenosis operations. We will detail how the implant is utilized, its intended purpose and what to expect as a recipient of the Coflex device.
Coflex Implant for Spinal Stenosis Indications
Paradigm Spine is the manufacturer of the Coflex spinal implant. The implant has been available in the United States since its approval as a medical device in 2012. The Coflex implant itself is surprisingly simple in design, being made of a single piece of titanium with no moving parts or method of fixation to the vertebral column. Instead of being fastened with screws or other surgical hardware, the device is held in place by the natural design of the spine, making it far more enlightened than many other products that do require fixation. After all, it is the process of fixation that is one of the leading cases of spinal implant and surgical hardware failure. The Coflex is placed between the spinal processes and its unique shape virtually guarantees that it will not slip or become displaced during normal use.
Unlike one of its main competitors, the X-Stop Implant, Coflex is not designed to allow patients to avoid traditional spinal stenosis surgery. Instead, the device is a complement for the usual path of surgical spinal canal decompression that either replaces the need for spinal fusion or works to build a more solid fusion. The reason the device can accomplish 2 seemingly opposing objectives is because there are 2 variations of the product available. The standard Coflex implant is used in place of spondylodesis surgery for vertebral column reconstruction and stabilization, while the Coflex-F is surgically bonded to the operated vertebrae when a fusion is judged to be necessary.
Coflex is approved for use in certain lumbar spinal stenosis scenarios and patients are carefully screened to ensure that their specific conditions will benefit from Coflex and that the device will not cause them any undue risks above and beyond the already substantial dangers of spinal stenosis surgery.
Coflex Implant for Spinal Stenosis Procedure
In order for either type of Coflex implant to be utilized, the patient must first undergo traditional spinal canal decompression surgery. This usually entails laminectomy, with the possible addition of add-on techniques such as foraminotomy or discectomy. Once all traces of canal impingement have been successfully resolved during decompression, the surgeon will need to make a determination if the spine is stable or has been left compromised by the various procedures used to remove the stenotic blockages. In most cases, the spine is judged to be compromised and would therefore normally require spondylodesis (also called fusion) surgery to preserve its structural integrity.
In these instances, the patients would traditionally have to undergo fusion of two or more vertebral bones. This is a technique that is fraught with complications and along with corpectomy, is the most risky of all spinal operations both immediately and eventually, since the procedure creates the ideal recipe for structural disaster as the spine continues to age.
If the surgeon has determined that the patient can avoid fusion by utilizing the Coflex implant, the device can be implanted rather quickly and with virtually no additional collateral damage to healthy tissues or surgical wounds. The Coflex will stabilize the spine after decompression, while eliminating the need for fusion surgery and hopefully reducing many of the complications associated with the fusion path of treatment.
If fusion is required, the surgeon will have the option of utilizing the Coflex-F device to strengthen the fusion bond, in order to facilitate faster healing and improve overall outcomes of the laminectomy/spondylodesis combination procedure.
It should be noted that the official name of the surgical technique utilizing Coflex is called Interlaminar Stabilization.
Coflex Implant for Spinal Stenosis Outcomes
Coflex is not a cure for stenosis, nor is it even a direct treatment for spinal stenosis. Instead, the curative portion of the operation consists of the decompression of the spinal canal and/or neuroforaminal spaces. This section facilitates the resolution of the symptomatic expression by freeing compressed nerve tissue and facilitating typical neurological communication between brain and body. The Coflex is only valuable for the repair of the spine following the often extensive damage suffered during the decompression procedure. However, since the normal Coflex allows the avoidance of fusion and the Coflex-F supports better fusion results, the device is still very valuable from a clinical perspective. We provide this critique, simply because many patients believe the device to be a cure in itself, which is simply incorrect.
We are very critical of spinal fusion, since it is overly used and abused in the back and neck pain treatment sectors of medical science. Fusion, much in the same manner as caesarian section, has become commonplace not due to its efficacy, but simply because it makes things much easier for the surgeon and also minimizes litigation risk. However, fusion is the absolute worst form of spinal surgery in its results and its fundamental engineering. We will not detail all the reasons for this truth in this particular article, as we have already written so much about spinal fusion elsewhere on the sites of The Cure Back Pain Network. Feel free to use our site search to find all of these articles for additional research. Let it suffice to say that it is far better to avoid fusion when this objective can be accomplished. The Coflex facilitates that exact goal, making it an enlightened product in our eyes.
The Coflex-F is different in that it is installed permanently into the vertebral column using traditional screws and is designed to support a fusion when one is deemed necessary. Once again, as stated before, fusion makes things much easier for the surgeon and most patients receive them simply so that the doctors can finish the surgery faster, easier and with less litigation risk compared to actually doing their job of healing with as little collateral trauma possible. This attitude is long gone in modern medicine, with time, money and convenience replacing the patient’s best interests at every turn.
We see lots of promise in the normal Coflex device and statistics show that it does provide benefits in terms of stability, fast healing and better physical functionality following decompression surgery, when compared to spinal fusion. This is no surprise since fusion is so inherently flawed.
The Coflex-F buys into those flaws and maybe helps to minimize them to a small degree. Fusions are said to heal faster when the device is used and are also said to become stronger. These are both positive attributes, but fusion is still a poor treatment option and will always demonstrate very significant risks for patients to consider.