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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\u20135 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\u2019s 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.<\/jats:p>","DOI":"10.3171\/2018.1.spine171360","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T14:28:27Z","timestamp":1529072907000},"page":"265-270","source":"Crossref","is-referenced-by-count":3,"title":["Coflex interspinous implant placement leading to synovial cyst development: case report"],"prefix":"10.3171","volume":"29","author":[{"given":"Seba","family":"Ramhmdani","sequence":"first","affiliation":[{"name":"The Spinal Column Biomechanics and Surgical Outcomes Laboratory and"},{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Comair","sequence":"additional","affiliation":[{"name":"Georgetown University, Georgetown College, Washington, DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilo A.","family":"Molina","sequence":"additional","affiliation":[{"name":"The Spinal Column Biomechanics and Surgical Outcomes Laboratory and"},{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M.","family":"Sciubba","sequence":"additional","affiliation":[{"name":"The Spinal Column Biomechanics and Surgical Outcomes Laboratory and"},{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Bydon","sequence":"additional","affiliation":[{"name":"The Spinal Column Biomechanics and Surgical Outcomes Laboratory and"},{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s10143-012-0394-1","article-title":"Role of lumbar interspinous distraction on the neural elements","volume":"35","author":"Alfieri A","year":"2012","unstructured":"Alfieri A, Gazzeri R, Prell J, Scheller C, Rachinger J, Strauss C, : Role of lumbar interspinous distraction on the neural elements. 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