VCOM Louisiana Research Day Program

Clinical & Case Studies

Joshua A. Torres, MS; Naveet Sharma, MD Edward Via College of Osteopathic Medicine; Green Clinic, Ruston 33 RETROSPECTIVE CHART REVIEW OF EXCISED TISSUE FOLLOWING MINIMALLY INVASIVE LUMBAR DECOMPRESSION PROCEDURE

Objective: Low back pain is one of the most common musculoskeletal problems globally and increases with advanced age. Hypertrophy or calcification of spinal tissues can cause lumbar stenosis, and often gives rise to neurogenic claudication. Initial conservative treatment includes pharmacologic management, physical therapy, or epidural steroid injections. If pain persists, surgical options including laminectomy, discectomy, or implantation of interspinous spacing devices can be explored. The MILD ® procedure previously displayed safety, robust longevity, and pain alleviating features in the 2-year MiDAS ENCORE randomized control study suggesting MILD ® as an excellent first-line therapy for patients with spinal stenosis. This study aims to highlight the range of hypertrophy and calcified changes found in excised tissues during the MILD ® procedure in patients with lumbar spinal stenosis. Design: The MILD ® procedure is executed percutaneously, entering via the posterior lumbar spine to access the interlaminar space under contrast-enhanced fluoroscopic guidance. When adequate lumbar decompression was achieved by excising hypertrophied structures, all devices were removed, and the access site was sealed with a sterile adhesive strip. Excised tissues were sent to pathology for analysis. Pathology

reports were reviewed to analyze the condition of excised tissues collected from 10 patients. Results: Upon review of pathology reports, excised tissues illustrated hypertrophy ranging up to 10mm and deposition of crystalline deposits in the ligamentum flavum. These findings are greater than the average hypertrophy values of 4-5mm previously published in the literature. Conclusions: As studies continue to demonstrate the benefits of the MILD ® procedure, literature does not characterize the condition of excised tissue that warranted the need for intervention. Highlighting the extent of pathologic change in tissues further supports the effectiveness and durability of the MILD ® procedure for pain relief in patients suffering from lumbar spinal stenosis.

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