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  • jason
    Member
    Post count: 2

    I have been in pain for over ten years and recently found I have facet on both sides of l4 l5 and want to make a change for the pain. I am 38 and worried about having several surgeries. Is coflex a safe product? I feel this is the best option but was only given 3 option. Fusion, coflex and pain management. What else is out there? also all my discs are degenerative in lower back I play all sports and have put a lot of wear on my back. my nerves are affected as well in the lower two discs. how long will the coflex last and why were they good for some but they still have pain ? Thanks.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    First you must understand that I do not think that Coflex is a useful product for most individuals. This device is designed to flex the two vertebra by wedging in between the two spinous processes. This position does not help the overall alignment of the lumbar spine and can be detrimental. I have taken out many Coflex devices that have eroded into the spinous processes or have caused more pain.

    The question that needs to be answered is what is causing your pain. Is it the facets, the instability of the level (degenerative facets are associated with degenerative spondylolisthesis and instability-see website) or compression of a nerve root or spinal canal (central stenosis)?

    If the pain is generated from nerve compression? Then you need a decompression. Is it from degenerative facets without instability? You might need facet rhizotomies (see website). Is the pain from instability? You might need a fusion. These surgical plans of course are determined if you have failed conservative treatment.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
    jason
    Member
    Post count: 2

    I am having pain on my right and left side which was explained to be the facet joint and when I lay strait it feels like its locking up I feel numbness in my legs due to compression or thining of discs. Maybe I should slow down and re think this. Although the neuro surgeons I have chose are award winning and tell me I will be fine . Can you tell me why they will not use coflex-f ? That seems more stabilizing. Thanks.

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    As i said before, the Coflex device is not something I would use due to the basic theory of its use. This device is designed to wedge between the two vertebra at the spinous processes. This causes the two vertebra to be forced into flexion which in turn causes deleterious effects on the rest of the lumbar spine. In addition, this device can erode into the spinous processes which can cause lower back pain and will lose its effectiveness when it erodes.

    Flexion does reduce the pressure on whatever structure is being compressed (lateral recess stenosis, foramina stenosis or central stenosis) but why not just decompress these structures in the first place? The surgeon should not just throw this device in. Take care of the structural problem and don’t put a bandaid on it.

    If the problem is back pain and instability, this device does not take care of this problem. The problem with instability is failure of the disc and facets. Putting this device in does not solve that problem.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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