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Lumbar Spinal Stenosis And Minimally Invasive Lumbar Decompression: A Narrative Review London Spine Lumbar Stenosis

The article discusses lumbar spinal stenosis (LSS) and the emerging minimally invasive treatment called MILD. The article’s objective is to review the efficacy, safety profile, procedure details, advantages, and limitations of MILD. The review focused on clinical trials of the MILD procedure and gathered information on indications, contraindications, pain scores, functional scores, effective rate, efficacy durations, and procedure details. The results showed that MILD reduced pain scores and improved functional status significantly, with an effective rate of 57.1%-88%. The long-term efficacy of MILD could not be determined based on the current literature. Overall, MILD is considered an effective and safe option for LSS patients who have failed conservative treatments but not for those requiring immediate invasive decompression surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated spine clinic in UK

Published article

Based on the reviewed literature, MILD is an effective and safe procedure. MILD can reduce pain intensity and improve functional status significantly. Therefore, it is a preferable option for LSS patients who failed conservative treatments, but not for those who require immediate invasive decompression surgery.

Spine Lumbar Spinal Stenosis Expert. Best Spinal Surgeon UK
Abstract Background: Lumbar spinal stenosis (LSS) is a common pain condition that causes lumbar back pain, radiating leg pain, and possible functional impairment. MILD is an emerging minimally invasive treatment for LSS. It is an image-guided percutaneous procedure designed to debulk hypertrophied ligamentum flavum. However, the exact short- and long-term efficacy, safety profile, indication criteria,

Abstract

Background: Lumbar spinal stenosis (LSS) is a common pain condition that causes lumbar back pain, radiating leg pain, and possible functional impairment. MILD is an emerging minimally invasive treatment for LSS. It is an image-guided percutaneous procedure designed to debulk hypertrophied ligamentum flavum. However, the exact short- and long-term efficacy, safety profile, indication criteria, and certain procedure details reported in medical literature vary.

Objective: This narrative review was to elucidate efficacy, safety profile, certain procedure details, advantages, and limitations of MILD.

Study design: This is a narrative review.

Setting: All included articles are clinic trials including analytic studies and descriptive studies.

Methods: PubMed, Cochrane Library, and Scopus were searched. Only clinical trials of MILD procedure were included. Information of indications, contraindications, VAS scores, ODI scores, effective rate, efficacy durations, and certain procedure details was focused on.

Results: According to the literature, for the MILD procedure, the VAS score could be reduced from a pre-treatment level of 6.3-9.6 to a post-treatment level of 2.3-5.8. The ODI score could be reduced from a pre-treatment level of 38.8-55.3 to a post-treatment level of 27.4-39.8. The effective rate of the MILD procedure was reported to be 57.1%-88%. A 2-year postoperative stability of efficacy was also supported. One RCT study testified superior efficacy of MILD over epidural steroid injection.

Limitations: There is few high-quality literature in the review. Moreover, the long-term efficacy of MILD cannot be revealed according to the current literature.

Based on the reviewed literature, MILD is an effective and safe procedure. MILD can reduce pain intensity and improve functional status significantly. Therefore, it is a preferable option for LSS patients who failed conservative treatments, but not for those who require immediate invasive decompression surgery.

Keywords: ligamentum flavum; low back pain; lumbar radiculopathy; lumbar spinal stenosis; mild®; minimally invasive lumbar decompression; neurogenic claudication.

The London Spine Unit : best situated spine clinic in UK

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Lumbar Spinal Stenosis and Minimally Invasive Lumbar Decompression: A Narrative Review

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Abstract Background: Lumbar spinal stenosis (LSS) is a common pain condition that causes lumbar back pain, radiating leg pain, and possible functional impairment. MILD is an emerging minimally invasive treatment for LSS. It is an image-guided percutaneous procedure designed to debulk hypertrophied ligamentum flavum. However, the exact short- and long-term efficacy, safety profile, indication criteria
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