<i>mild</i> Procedure for Lumbar Decompression: A Review

Chen, Hamilton; Kelling, Jonathan

doi:10.1111/j.1533-2500.2012.00574.x

Cited by 18 publications

(16 citation statements)

References 27 publications

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“…There is known potential for significant morbidity and mortality associated with LL. [1][2][3] Current literature suggests that placement of an interspinous spacer (ISS) is a less invasive and potentially equally effective treatment option when compared to LL [4][5][6][7] ; however, systematic reviews of primary research have demonstrated that use of ISS devices is associated with higher costs and reoperation rates. [8][9][10] Still, the causes of the higher reoperation rate were not identified.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Adverse Outcomes Following Placement of Superion Interspinous Spacer Device Versus Laminectomy and Laminotomy

et al. 2021

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Background: Current evidence suggests placement of the Superion interspinous spacer (SISS) device compared with laminectomy or laminotomy surgery offers an effective, less invasive treatment option for patients with symptomatic lumbar spinal stenosis. Both SISS placement and laminectomy or laminotomy have risks of complications and a direct comparison of complications between the 2 procedures has not been previously studied. The purpose of this study is to compare the short-term complications of the SISS with laminectomy or laminotomy and highlight device-specific long-term outcomes with SISS.Methods: Via retrospective review, 189 patients who received lumbar level SISSs were compared with 378 matched controls who underwent primary lumbar spine laminectomy or laminotomy; data were collected from the American College of Surgeons National Surgical Quality Improvement Program database. Complications analyzed included rates of wound infection, pulmonary embolism, deep venous thrombosis, urinary tract infection, sepsis, septic shock, cardiac arrest, death, and reoperation within 30 days of index surgery. Differences between groups were analyzed using the v 2 test. Device-specific complication (DSC) rates included device malfunction or misplacement (DM), device explantation (DE), spinous process fracture (SPF), and subsequent spinal surgery (SSS).Results: No differences in demographics or comorbidities existed between groups. There was no significant difference in rates of complications between groups. A total of 44.4% of patients in the SISS group experienced DSCs with 11.1% of patients experiencing DM, 21.1% experiencing an SPF, 20.1% requiring DE, and 24.3% requiring SSS. Having at least 1 DSC significantly increased odds of SSS, odds ratio .120, P , .0001.Conclusion: Rates of 30-day complications in the SISS group were not significantly different from patients undergoing laminectomy or laminotomy. Rates of 2-year DSC within SISS and cumulative risk associated with these complications should be considered further as they likely represent need for additional procedures for patients and substantial cost to the healthcare system.Level of Evidence: 4. Clinical Relevance: Having no differences in adverse events between laminectomies or laminotomies and SISS plus evidence of substantial device-specific long-term adverse outcomes and reoperation should be given consideration when deciding on surgical intervention of 1-2 level lumbar spinal stenosis.

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Section: Introductionmentioning

confidence: 99%

Comparison of Adverse Outcomes Following Placement of Superion Interspinous Spacer Device Versus Laminectomy and Laminotomy

et al. 2021

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“…The literature on MILD is still maturing, as most of the published studies are case series not randomized controlled trials . However, these studies have shown great benefit in improving patient symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…MILD was met with both optimism and skepticism. Many case reports and retrospective observational studies supported MILD's claims, but unfortunately, there has been a lack of evidence from prospective blinded trials . None of the current literature on MILD examined how it could affect health care costs.…”

Section: Introductionmentioning

confidence: 99%

Decrease in Health Care Resource Utilization with MILD

et al. 2013

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“…The standard methodology used to perform percutaneous lumbar decompression has been previously described .…”

Section: Methodsmentioning

confidence: 99%

Systematic Safety Review and Meta-Analysis of Procedural Experience Using Percutaneous Access to Treat Symptomatic Lumbar Spinal Stenosis

Levy

Deer

2012

Pain Med

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In this safety review, percutaneous lumbar decompression proved to be a safe procedure. Compared with other more invasive lumbar decompression techniques, percutaneous lumbar decompression has demonstrated significantly better safety. This high level of safety is particularly vital for the rapidly growing elderly LSS patient population with increased treatment risks related to comorbid medical issues.

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mild Procedure for Lumbar Decompression: A Review

Cited by 18 publications

References 27 publications

Comparison of Adverse Outcomes Following Placement of Superion Interspinous Spacer Device Versus Laminectomy and Laminotomy

Comparison of Adverse Outcomes Following Placement of Superion Interspinous Spacer Device Versus Laminectomy and Laminotomy

Decrease in Health Care Resource Utilization with MILD

Systematic Safety Review and Meta-Analysis of Procedural Experience Using Percutaneous Access to Treat Symptomatic Lumbar Spinal Stenosis

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