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.
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.