Minimally Invasive Procedure Relieves Spinal Stenosis Symptoms

The Vertos Medical (Aliso Viejo, CA, USA) mild device kit and procedure are designed to remove hypertrophic ligamentum flavum through a 5.1-mm treatment portal via a posterior approach using live fluoroscopy. Specialized instruments are then used to debulk the hypertrophic tissue while maintaining the integrity of the ventral fibers of the ligamentum flavum by staying posterior to the thecal sac. The restoration of space in the spinal canal reduces pressure on the nerve bundles, reduces pain, and improves mobility.

To maintain safety, an epidurogram is used to allow physicians constant visualization of the treatment area throughout the procedure. Another safety feature is the minimally invasive design of the procedure itself, which requires no general anesthesia, no implants, no stitches, and is performed in about one hour. Clinical research has demonstrated that around 80% of patients experience a significant reduction in pain and improvement in standing time and walking distance, even in the presence of other LSS causal factors.

“There are millions of patients currently suffering from the debilitating effects of lumbar spinal stenosis who are looking for new treatment options that are safe, effective, and treat the underlying cause of stenosis,” said Eric Wichems, President and CEO of Vertos Medical. "We are pleased that we are able to expand access to the mild procedure.”

“This is an excellent treatment for patients who formerly relied upon epidural steroid injections, physical therapy, and/or medications to relieve their pain,” said interventional physiatrist Lan Fotopoulos, MD, of Dickson Diveley Midwest Orthopaedic Clinic (Leawood, KS, USA). “In less than an hour, we can remove small pieces of bone and excess ligament using an imaging machine along with specialized tools through one tiny incision in the back. Once completed, space is restored to the spinal canal and compression is alleviated from the nerves. Think of this as something similar to removing a kink in a drinking straw or a garden hose.”

LSS is a degenerative, age-related narrowing of the lower spinal canal that causes compression of the nerve roots and subsequent neurogenic claudication symptoms in the lower back, legs, or buttocks that worsen with lumbar extension (standing or walking) but improve with lumbar flexion (sitting or bending forward). The narrowing is caused by degenerative changes in the lumbar spine and is often multi-factorial in nature, with common co-factors including disc bulge, osteophytes, and ligamentum flavum hypertrophy.

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