Presented at the 2012 AAPM Annual Meeting « Back

Long-Term Improvements Show Mild® Percutaneous Procedure Durability

Timothy R. Deer, MD, doctdeer@aol.com, The Center for Pain Relief, Charleston, West Virginia

Introduction: When nonsurgical approaches become inadequate in alleviating symptoms of neurogenic claudication in lumbar spinal stenosis (LSS) patients, surgery is usually considered. Surgical options range from minimally invasive decompression to open laminectomy with fusion. As a minimally invasive alternative to open surgery, the mild decompression procedure is performed through a tiny portal under fluoroscopic guidance. Mild minimizes injury to surrounding soft tissue, bone, and ligament. Further, general anesthesia is not required and patients are generally discharged on the same day as the procedure. Mild offers a new option for LSS patients suffering from neurogenic claudication, who are unwilling or not medically indicated to undergo open surgery. Objective: To assess patient outcomes 2 years after lumbar decompression with mild. Materials and Methods: Patients diagnosed with radiographically confirmed LSS exhibiting symptoms of neurogenic claudication were treated in this IRB-approved, prospective, multicenter study. Posttreatment outcome measurements include Visual Analog Score (VAS), Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and SF-12v2® Health Survey. Poststudy follow-up was obtained through Year 2. This study was registered on the U.S. Clinical Trial Registry. Results: Through 2-year follow-up, no serious mild safety issues were reported. Patients achieved and maintained significant pain reduction as measured by VAS, ZCQ, and SF-12v2. Significant physical function and mobility improvement were confirmed using ODI, ZCQ, and SF-12v2. Conclusions: Based on 2-year posttreatment results, mild provides durable improvement in pain, mobility, and physical quality of life for LSS patients. The mild procedure is a safe option in the LSS treatment algorithm.

Funding: None