Vertos Medical Clinical Publication

Minimally Invasive Direct Decompression for Lumbar Spinal Stenosis: Impact of Multiple Prior Epidural Steroid Injections

Source— Pain Management Author— Peter Pryzbylkowski, Anjum Bux, Kailash Chandwani, Vishal Khemlani, Shawn Puri, Jason Rosenberg, Harry Sukumaran Published August 4, 2021

Physicians use an algorithm to decide how best to treat lumbar spinal stenosis (LSS) that results from abnormal thickening of the spinal ligaments that run the length of the spinal cord. Early treatments can include one or more epidural steroid injections (ESIs). The purpose of this study was to evaluate a change to the algorithm that involves earlier intervention with a minimally invasive, short outpatient procedure that removes a major root cause of the abnormal thickening (lumbar decompression) and leaves no implants behind.

Records of patients treated with minimally invasive lumbar decompression (mild®) after receiving either a single ESI procedure or none at all, were compared with the records of patients who underwent the mild® Procedure after receiving two or more ESIs (145 total patients). The patients’ pain scores before surgery, at one-week post-surgery, and at three months post-surgery were reviewed.

This study suggests that there appears to be no benefit to having multiple ESIs before undergoing the mild® Procedure and thus the authors recommend that the algorithm be modified to perform the mild® Procedure either as soon as LSS is diagnosed or after the failure of the first ESI.

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To learn more and hear from the author, check out Dr. Pryzbylkowski’s American Society of Pain & Neuroscience (ASPN) Abstract Blog and view his award-winning ASPN 2021 “Top 25 Abstract” below.

Infographic showing the impact of moving to the mild Procedure directly or after initial epidural steroid injection (ESI) failure


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