Vertos Medical Clinical Publication

Understanding Whether Chronic Lower Back Pain Patients with Lumbar Spinal Stenosis Benefit From Multiple Epidural Steroid Injections Prior to the mild® Procedure

Source— Pain Management Author— Peter Pryzbylkowski, Anjum Bux, Kailash Chandwani, Vishal Khemlani, Shawn Puri, Jason Rosenberg & Harry Sukumaran Published November 9, 2021

Originally published in Pain Management, this article is a summary of a study performed to look at the benefit, if any, of more than one epidural steroid injection (ESI) in the spine before the mild® Procedure. Minimally invasive lumbar decompression (commonly known as the mild® Procedure) and ESIs are both common treatment options for lumbar spinal stenosis (LSS), a condition that causes chronic lower back pain in older adults.

To determine how to best treat LSS patients, healthcare professionals use a guide to help with the decision-making process (called an algorithm) to pass through non-medical to more invasive therapies that often includes one or more ESIs. An ESI is medication inserted in the lower back to reduce swelling and provide relief from pain. Researchers wanted to look at a change to when in the treatment process the mild® Procedure is carried out.

In the study, researchers compared the medical records of participants who had received either just one or no steroid injection prior to the mild® Procedure, to participants who received two or more epidural steroid injections prior to the mild® Procedure. Similar outcomes in both treatment groups in this study proved that giving more than one ESI prior to mild® did not improve how well patients did and may have delayed patient care.

Based on the results of the study, it is recommended that the standard treatment process for LSS patients be changed to give the mild® Procedure either, as soon as LSS is diagnosed or after the failure of the first ESI.

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