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Coflex and Cofix
Understanding Your Surgical Options
Below you’ll find two detailed, patient‑friendly guides, one for Coflex® Interlaminar Stabilization and one for Cofix™ Posterior MIS Fusion. Both devices are placed between the spinous processes after the surgeon removes pressure from the nerves, but they serve different goals. Review the information at your own pace, jot down any questions, and bring them to your pre‑op visit. This webpage is educational and not a substitute for the personal advice of your neurosurgeon.
Coflex® Interlaminar Stabilization
What is Coflex?
Coflex is a small titanium implant that sits between the bones at the back of the spine (the spinous processes). It supports the spine after a lumbar (lower back) decompression while still allowing motion. The U‑shape cushions the segment like a “flexible door‑stop,” preventing the level from collapsing yet avoiding a rigid fusion.
Who is a Candidate?
Adults who have moderate‑to‑severe lumbar spinal stenosis (L1–L5) that improves when bending forward.
Completed at least 6 months of non‑surgical care (therapy, injections, medication) without lasting relief.
Require surgery at only one or two levels.
Have no spinal instability greater than grade 1 spondylolisthesis, severe osteoporosis, or active infection.
Benefits Versus Fusion
Preserves mobility.
Shorter incision and less muscle dissection.
No pedicle screws or bone grafts required.
Typically same‑day or 1‑night stay at the hospital following surgery.
The Surgical Day – What to Expect
Outpatient or overnight stay under general anesthesia.
Microsurgical decompression (laminotomy/laminectomy) removes the bone and ligament pressing on nerves.
The Coflex implant is gently tapped into place between the spinous processes.
Surgery time is usually 60–90 minutes, depending on the amount of decompression required.
Recovery & Activity Timeline
Day 0–1: Walk the same day; go home once walking safely with minimal pain.
Weeks 1–2: Light daily activities at home; avoid lifting > 5 kg.
Weeks 3–6: Begin formal physical therapy; gradual return to desk work or light duties.
Weeks 6–12: Resume most activities, including driving and low‑impact exercise.
After 3 months: Progressive return to golf, cycling, swimming; discuss heavier sport with your surgeon
*Timelines vary—follow your surgeon’s personal instructions.
Possible Risks & Complications
Continued or recurrent leg/back pain.
Implant migration or spinous‑process fracture (< 1 %).
Infection, bleeding, dural tear, nerve injury.
Need for revision or future fusion at the treated or adjacent level (small risk).
Frequently Asked Questions
Cofix™ Posterior MIS Fusion
What is Cofix?
Cofix is an interlaminar fixation system that includes a clamp‑like implant plus small screws and sleeves. It stabilizes the treated level so that the bones can fuse together, but through a far smaller incision than traditional pedicle‑screw fusion.
Who is a Candidate?
Patients needing lumbar fusion for spondylolisthesis (up to grade 1), disc degeneration, or after decompression.
Situations where the surgeon wants to avoid larger rods and screws.
One or two lumbar levels, with adequate bone quality to accept the device.
Benefits Compared with Standard Fusion
Minimally invasive midline approach, shorter scar, less muscle disruption.
May reduce operating time and blood loss.
Allows the surgeon to pair the device with an interbody cage if needed.
Less hardware prominence under the skin.
The Surgical Day – What to Expect
General anesthesia; often outpatient or one‑night stay.
Nerve decompression → placement of bone graft or interbody cage → positioning of the Cofix clamp and two small screws.
Fluoroscopy (x-ray) confirms placement.
Typical operative time: 90–120 minutes.
Recovery & Activity Timeline
Day 0–1: Stand and walk with a brace, go home with oral pain meds.
Weeks 1–4: Keep incision clean, avoid bending/twisting; limit lifting > 2–3 kg.
Weeks 4–12: Begin core‑strengthening and gentle aerobic exercise; increase sitting tolerance for work.
3–6 months: Fusion mass hardens—gradual return to heavier lifting/sports per imaging confirmation.
*Exact plan tailored by your surgeon and physical therapist.
Possible Risks & Complications
Non‑union (fusion does not solidify) requiring further surgery.
Adjacent‑segment degeneration over time.
Hardware loosening or breakage.
Standard surgical risks: infection, bleeding, nerve or dural injury.
Frequently Asked Questions
Preparing for Surgery
Stop nicotine products at least 4 weeks before surgery, smoking delays healing.
Review your medications; you may need to pause blood thinners or diabetic drugs.
Arrange help at home for the first few days (meals, laundry, pet care).
Stay active—simple walks and core‑strength exercises improve post‑op recovery.
Maintain balanced nutrition, adequate protein, and vitamin D.
When to Call the Office After Surgery
Fever > 101 °F (38.3 °C) or chills.
Wound redness, swelling, or drainage.
New or worsening leg weakness/numbness.
Severe calf pain or swelling (possible blood clot).
Uncontrolled pain despite medication.
Key Take‑Aways
Coflex preserves motion and is best when stability, not fusion, is required after decompression.
Cofix provides rigid fixation in a minimally invasive way to help bones fuse without large rod‑and‑screw constructs.
Both options aim to relieve leg pain, restore function, and get you back to walking sooner than older, more invasive techniques.
Always discuss the pros and cons with your neurosurgeon. Your individual anatomy, lifestyle, and health conditions will guide the final decision.
