Background: Symptomatic lumbar spinal stenosis (LSS) patients often suffer from multiple etiologies,
and patient symptoms must be differentiated and identified as either neurogenic claudication, radicular
pain, or both. The most common symptom associated with LSS is neurogenic claudication, which has been
reported to occur in 91% to 100% of the LSS patient population. Neurogenic claudication symptoms are
described as pain radiating to the lower extremities that begins and worsens as the patient ambulates.
Neurogenic claudication symptoms worsen over time and can eventually result in significant life-altering
functional limitations. Symptomatic LSS patients may also suffer from radicular pain, which is a persistent
pain transmitted through neural pathways, and is associated with inflammation of the exiting nerve root.
Objective: To assess patient safety, pain reduction, and functional status of patients treated with
percutaneous lumbar decompression.
Study Design: Single-center, prospective clinical study of 46 consecutive patients with neurogenic
claudication symptoms related to lumbar spinal stenosis.
Setting: US interventional pain management practice.
Methods: From March 2010 to January 2011, 46 LSS patients suffering from neurogenic claudication
underwent mild percutaneous lumbar decompression. Of these, 12-week, 6-month and one-year followup was available for 35 patients.
Outcome Assessment: Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Zurich
Claudication Questionnaire (ZCQ). Outcomes were assessed at baseline, 12-week, 6-month and one-year
follow-up.
Results: One-year follow-up patients in this study experienced statistically and clinically significant
improvement in physical function, as well as reduction of pain intensity. The initial improvement in these
patients, which was significant, was sustained through one year, with no significant differences among
the interim follow-up visit periods. These results demonstrate early improvement following treatment with
a high degree of durability over time. There were no serious device or procedure-related complications
reported in this study.
Limitations: Single-center study with no control group.
Conclusions: In this study, the mild procedure was shown to be safe. In addition, patients experienced
significant improvement in mobility and reduction of pain one year after the procedure. One-year
outcomes were not significantly different from interim results, indicating that the significant improvement
following treatment, occurring as early as 12 weeks, was maintained through one year. This high degree
of consistency over time indicates the durability of percutaneous lumbar decompression in the treatment
of neurogenic claudication in symptomatic LSS.
Key words: Spine, lumbar, lumbar spinal stenosis, neurogenic claudication, decompression, ligamentum
flavum, mild, percutaneous.
Full-Endoscopic Lumbar Decompression versus Open Decompression and Fusion Surgery for the Lumbar Spinal Stenosis: A 3-Year Follow-Up Study
