Minimally Invasive Lumbar Decompression and Interspinous Process Device for the Management of Symptomatic Lumbar Spinal Stenosis: a Literature Review

2020 ◽  
Vol 24 (4) ◽  
Author(s):  
Justin Merkow ◽  
Narayana Varhabhatla ◽  
Laxmaiah Manchikanti ◽  
Alan D. Kaye ◽  
Richard D. Urman ◽  
...  
Keyword(s):  
Literature Review ◽  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Lumbar Decompression ◽  
Interspinous Process Device ◽  
Lumbar Spinal

scholarly journals Retrospective Review of Patient Self-Reported Improvement and Post-Procedure Findings for mild® (Minimally Invasive Lumbar Decompression)

2010 ◽  
Vol 6;13 (6;12) ◽  
pp. 555-560
Author(s):  
Jay S Grider
Keyword(s):  
Adverse Events ◽  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Neurogenic Claudication ◽  
Lumbar Decompression ◽  
Post Procedure ◽  
Lumbar Spinal ◽  
Major Adverse Events

Background: Lumbar spinal stenosis and neurogenic claudication functionally impact thousands of patients per year. Those who fail conservative therapies and are not surgical candidates due to co-morbid conditions have few interventional options available. The recently described mild® procedure (Minimally Invasive Lumbar Decompression) is a candidate to fill this void. While 2 studies have reported no major adverse events with this procedure, the typical post-procedure patient course has not been previously described. Objective: To examine the minor adverse events and periprocedural course associated with mild. Additionally, to evaluate the efficacy of the procedure with regard to pain relief and functional status. Design: Retrospective evaluation. Methods: Forty-two consecutive patients meeting magnetic resonance imaging (MRI) criteria for mild underwent the procedure performed by 2 interventional pain management physicians working at the same center. The pre and post procedure visual analog scale (VAS) as well as markers of global function were recorded. Major and minor adverse events were tracked and patient outcomes reported. Results: There were no major adverse events reported. Of the minor adverse events, soreness lasting 3.8 days was most frequently reported. No patients required overnight observation and only 5 required postoperative opioid analgesics. Patients self-reported improvement in function as assessed by ability to stand and ambulate for greater than 15 minutes, whereas prior to the procedure 98% reported significant limitations in these markers of global functioning. Visual analog pain scores were significantly decreased by 40% from baseline. Eighty-six percent of the patients reported that they would recommend the mild procedure to others. Conclusions: The mild procedure appears to be a safe and likely effective option for treatment of neruogenic claudication in patients who have failed conservative therapy and have ligamentum flavum hypertrophy as the primary distinguishing component of the stenosis. Key words: Minimally invasive lumbar decompression, lumbar spinal stenosis, neurogenic claudication, fluoroscopy, ligamentum flavum

scholarly journals The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis

2020 ◽  
Vol Volume 13 ◽  
pp. 151-161
Author(s):  
Nagy A Mekhail ◽  
Shrif J Costandi ◽  
Sherif Armanyous ◽  
Ricardo Vallejo ◽  
Lawrence R Poree ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Lumbar Decompression ◽  
Lumbar Spinal ◽  
The Impact

scholarly journals Minimally invasive lumbar decompression: a review of indications, techniques, efficacy and safety

2020 ◽  
Vol 10 (5) ◽  
pp. 331-348 ◽  
Author(s):  
Sameer Jain ◽  
Timothy Deer ◽  
Dawood Sayed ◽  
Pooja Chopra ◽  
Sayed Wahezi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Treatment Guidelines ◽  
Treatment Algorithm ◽  
Neurogenic Claudication ◽  
Efficacy And Safety ◽  
Safety And Efficacy ◽  
Lumbar Decompression ◽  
Lumbar Spinal

Lumbar spinal stenosis is a common degenerative spine condition. In properly selected patients, minimally invasive lumbar decompression ( mild®) may be an option to improve outcomes. This review provides an in-depth description of the mild procedure and a comprehensive examination of safety and efficacy. Two randomized controlled trials, together with 11 other controlled clinical studies, have established the efficacy of mild, which is a minimally invasive procedure that does not involve implants and has demonstrated excellent efficacy and safety. With an established safety profile equivalent to epidural steroid injections, and efficacy that has been shown to be superior to such injections, mild can reasonably be positioned early in the treatment algorithm for these patients. Based on extensive review of the literature, robust safety and efficacy through 2 years, and in accordance with minimally invasive spine treatment guidelines, mild is recommended as the first intervention after failure of conservative measures for lumbar spinal stenosis patients with neurogenic claudication and ligamentum flavum hypertrophy.

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