Mild interlaminar decompression for the treatment of lumbar spinal stenosis: Procedure description and case series with 1-year follow-up

摘要

Objectives: mild interlaminar decompression is a minimally invasive procedure for the treatment of patients with symptomatic lumbar spinal stenosis. This report describes the mild procedure and presents 1-year clinical outcomes of patients treated with mild. Methods: mild treats lumbar spinal stenosis by removing portions of the lamina and ligamentum flavum to restore space in the lumbar spine. The procedure is conducted under fluoroscopic guidance, and is performed with moderate sedation. One-year follow-up was obtained for 17 patients treated with the mild procedure. Clinical evaluations were conducted at baseline and at 1-year follow-up with the 10-point Visual Analog Score and Oswestry Disability Index. Results: mild treatments were completed with no major device-related or procedure-related complications. The baseline mean Visual Analog Score of 7.6 improved at 1 year after the procedure to 2.3, a decrease of 5.4 cm points, or an average percentage decrease of 70.0%. Average baseline Oswestry Disability Index of 48.4 improved to 21.7 at 1 year, an improvement of 26.6 points. Discussion: The mild technique provides an attractive early option for the treatment of symptomatic lumbar spinal stenosis after failed injection therapy, but before more invasive surgical treatment. For 17 patients with 1-year follow-up, the mild procedure provided significant pain relief and increased mobility. This procedure leaves no implants behind, and therefore does not limit subsequent, more invasive procedures that require implants.