Coflex interspinous implant placement leading to synovial cyst development: Case report

Seba Ramhmdani, Marc Comair, Camilo A. Molina, Daniel Sciubba, Ali Bydon

Research output: Contribution to journalArticle

Abstract

Interspinous process devices (IPDs) have been developed as less-invasive alternatives to spinal fusion with the goal of decompressing the spinal canal and preserving segmental motion. IPD implantation is proposed to treat symptoms of lumbar spinal stenosis that improve during flexion. Recent indications of IPD include lumbar facet joint syndrome, which is seen in patients with mainly low-back pain. Long-term outcomes in this subset of patients are largely unknown. The authors present a previously unreported complication of coflex (IPD) placement: the development of a large compressive lumbar synovial cyst. A 64-year-old woman underwent IPD implantation (coflex) at L4-5 at an outside hospital for low-back pain that occasionally radiates to the right leg. Postoperatively, her back and right leg pain persisted and worsened. MRI was repeated and showed a new, large synovial cyst at the previously treated level, severely compressing the patient’s cauda equina. Four months later, she underwent removal of the interspinous process implant, bilateral laminectomy, facetectomy, synovial cyst resection, interbody fusion, and stabilization. At the 3-month follow-up, she reported significant back pain improvement with some residual leg pain. This case suggests that facet arthrosis may not be an appropriate indication for placement of coflex.

Original languageEnglish (US)
Pages (from-to)265-270
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume29
Issue number3
DOIs
StatePublished - Sep 1 2018

Keywords

  • Coflex interspinous implant
  • Lumbar spinal stenosis
  • Surgical technique
  • Synovial cyst

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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