Development of Bilateral Facet Cysts Causing Recurrent Symptoms After Decompression and the Placement of an Intralaminar Implant: A Case Report.

CASE: We report the development of bilateral symptomatic facet joint cysts in a 78-year-old man who had been treated with decompression and placement of a coflex device (Paradigm Spine) at L3-L4 and L4-L5. Preoperative imaging clearly demonstrated fluid in the facet joints without cysts. He underwent standard surgical treatment, but developed symptomatic facet joint cysts at 4 months postoperatively. The patient was treated with a revision decompression and replacement of the devices; there were no issues at the 32-month follow-up.

CONCLUSION: While the coflex device has possible long-term biomechanical advantages, vigilance with adherence to appropriate decompression surgical technique is necessary.