Carving Ligaments Alleviates Spinal Stenosis Pain

Researchers at Massachusetts General Hospital (MGH, Boston, MA, USA) performed a minimally invasive lumbar decompression (MILD) procedure under radiological guidance on ten patients. Neurointerventional practitioners worked through a metal cannula, which was inserted through a small incision in the skin directly at the sight of the problem area. The practitioners then removed the bone--a procedure known as a laminotomy--and afterwards sculpted the enlarged ligaments that compressed the nerve roots, using a special device named Vertos placed inside the cannula. Because this minimally invasive procedure allows practitioners to remove targeted portions of the bone, MILD has the advantage of protecting against the destabilization of the spine during the procedure. As with other minimally invasive treatments, patients also benefit from local anesthesia, as well as same- or next-day discharge. The ten patients at MGH were followed under an internal review board (IRB)-approved protocol designed to assess improvement of pain and disability with commonly used measurement instruments, as well as review narcotic intake. At six weeks post-treatment, the mean pain score decreased 90% and the mean disability score improved 84%, compared to baseline. Additionally, all 10 patients discontinued narcotics use for pain. The study was presented at the Society of Neurointerventional Surgery (SNIS) annual meeting, held during July 2008, in Lake Tahoe (CA, USA). The Vertos device, a product of Vertos Medical (San Jose, CA, USA), has been approved by the U.S. Food and Drug Administration (FDA).

"The beauty of this procedure is that we have the opportunity to restore quality of life to hundreds of thousands of patients who are affected by LSS with an incision far smaller than a dime,” said study presenter Joshua Hirsch, M.D., director of interventional neuroradiology and endovascular neurosurgery and chief of minimally invasive spine surgery at MGH. "It is revolutionary therapies like this one that are giving neurointerventional practitioners the opportunity to change the entire landscape of patient care.”

LSS is a narrowing of the spinal canal in the lower back, known as the lumbar area. This narrowing occurs when bone and ligament growth restricts the canal, squeezing and irritating the nerves that branch out from the spinal cord. This compression causes patients to experience low back pain, leg fatigue and pain, and in severe cases, a significant reduced capacity for physical activity, including walking.

Related Links:
Massachusetts General Hospital
Vertos Medical