Lumbar Spinal Stenosis Surgery

May Press Release

05/15/2012

ROBERT B. WILSON, II, MD, FIRST IN CHARLOTTE METRO REGION TO PERFORM THE MILD PROCEDURE FOR LUMBAR SPINAL STENOSIS.

Salisbury, North Carolina – Betty Bowen, 72, is the type of woman who will bend over backwards to help someone. But due to a debilitating condition, lumbar spinal stenosis (LSS), Betty was on a downward spiral where even bending over wasn’t possible anymore without extreme pain.

Betty explained it started when the riding lawn mower Betty was driving flipped over, and she hurt her back. The pain was immediate and intense, and over time she had to give up her work at a local school because it was difficult to even walk. Betty was used to being active. Having assisted aging parents, Betty is the sole caregiver for her husband – but she found it hard to even stand long enough to prepare a meal. Betty clearly needed a solution – one that didn’t require major surgery and without strong medications.

Piedmont Interventional Pain Care (PIPC) in Salisbury, North Carolina, had a solution: the mild procedure. Developed by Vertos Medical, mild is the first therapeutic option to provide rapid and lasting pain relief from LSS, as well as significantly improving mobility without surgery.

Dr. Robert B. Wilson, II, Board Certified Pain Medicine Physician and Anesthesiologist, and Medical Director of PIPC, has always been very determined to bring new and effective interventional procedures to pain patients in the region. As the first in the southeast to implant a spinal cord stimulation system with a three-lead array, Dr. Wilson was pleased to accept the invitation by Vertos Medical to participate in its physicians training program.

Now one of the first pain physicians in North Carolina to complete his training for the mild procedure, Dr. Wilson determined Betty was a great candidate for the procedure.

“I’ve dealt with back pain and sciatica for three years and tried nearly all I could for relief,” Betty said. Though she tried ice packs, heating pads and medicines, nothing would relieve the pain. Over time, the pain from the LSS only got worse.

“When I met Dr. Wilson, I instantly liked him and trusted him. He took his time and explained everything to me,” she explained.  Betty said the medical team was supportive throughout the entire experience.

Dr. Wilson said the mild procedure is important to aging patients who don’t have a surgical option otherwise and have reduction in function due to the LSS and pain and weakness in the back and legs. “Generally an interventional pain physician performs this procedure when other injections have failed to benefit the patient. It is safe, effective and can be performed in the operating room with local anesthesia and does not require a general anesthetic or a lengthy surgery,” he said.

“Betty’s outcome was as good as we could have hoped for considering her spine and the lack of any sustained benefit from injections. She is sleeping all night, now, where she couldn’t before and is able to walk further without stopping to rest. She had improved function in only a couple of days after the procedure,” he continued.

“We medically and physically evaluate a patient and take many factors into consideration to determine a good candidate for the mild procedure. This procedure is designed to remove the swollen ligamentous tissue to allow expansion of the spinal canal and reduce the symptoms of LSS. The classic LSS patient experiences low back and hip pain after only 5-10 minutes of movement. The pain requires the patient stop and rest for a period of time and after getting pain relief from sitting, they can then walk again for a few minutes before needing to sit down.”

An MRI or a CT scan helps to diagnose the pathology of exactly what is causing the LSS. Some degenerative conditions of the lumbar spine would not be conducive to being improved by the mild procedure, so it is important to be thorough in making the determination,” Dr. Wilson said.

Cleared by the U.S. Food and Drug Administration for decompression of the lumbar spine, mild removes small portions of the bone and tissue reducing the pressure on the nerves through a low-risk posterior approach. The entire procedure takes place using a 5.1 mm mild Portal, only about the diameter of a pencil.

The safe, therapeutic nature of the mild procedure allows for shorter in-patient therapy and recovery time compared to other open surgical treatment options such as laminotomy, laminectomy and spinal fusion for LSS. Patients who undergo mild are typically discharged the day of the procedure. The mild procedure can be performed using fluoroscopic guidance in an outpatient surgical suite under local anesthesia.

“The procedure was easy,” Betty said. “It was done in the outpatient surgery center, and I was ready to go home after a couple of hours.”

When she returned for her follow up a couple of weeks later, she said there were just four tiny places where she had stitches. “I was just amazed when the bandage came off.”

“I never would have dreamed I would feel this good! I feel great…I feel stronger…and more balanced – and I feel a foot taller! ” she quipped. For the first two weeks, she had to take it easy, no bending or squatting. After that, she said her soreness was gone. “I am just so thankful. I feel like a different person…I can walk, stand and move around…and I sleep better. I feel like it is a miracle!”

 

About Lumbar Spinal Stenosis

Each year, over 1.2 million people in the United States are diagnosed with Lumbar Spinal Stenosis (LSS). LSS is a narrowing of the lower spinal canal, which may cause pain and numbness that limits the ability to walk or stand. Usually found in people over 50 years of age, the likelihood of developing LSS increases with age.

The spine provides support for your back and body. It also protects the spinal cord, the bundle of nerve tissues that runs from your brain to your lower body. The bony channel that encloses the spinal cord is called the spinal canal. Usually, there is enough space between the spinal cord and the spinal canal so the nerves that flow through and exit the spinal canal are free of obstruction.

As the body ages, however, the ligaments and bones outside the spinal canal may thicken and begin to press on the spinal canal, causing it to narrow. This narrowing of the spinal canal is called spinal stenosis. In fact, stenosis is a Greek word that means choking, which describes what happens to the spinal cord. When stenosis occurs in the lower part of the spine, it’s called lumbar spinal stenosis. This narrowing of the canal can compress or pinch nerve tissues, resulting in pain, numbness and limited mobility.

About the mild Procedure

The FDA approved mild procedure is a new, minimally invasive approach to reduce pain and improve mobility in LSS patients. Thousands of patients have been treated by mild, which is enabled by an innovative new technology and can only be performed by specially trained physicians. The safety and efficacy of mild have been demonstrated in several clinical studies, which are published in leading scientific journals. For patients suffering from the pain and physically limiting effects of LSS, this offers a non-surgical option for relief.

Unlike some treatments that may only temporarily address symptoms, mild safely and effectively addresses the underlying cause of pain and immobility in patients with LSS. Compared to more invasive surgical procedures that require general anesthesia, mild can be performed in an outpatient setting under local anesthesia or light sedation, and patients experience fewer complications. Also, procedure and recovery times are generally reduced compared to more invasive procedures, after which patients may need rehabilitation or physical therapy.

 

What patients can expect with mild:

  •  Minimally invasive procedure through a tiny incision, requiring no stitches.
  • Local anesthetic and light sedation is typical.
  • Fast procedure time, usually performed in 1 hour.
  • Generally return home the same day.
  • Often return to work and resume light daily tasks within a few days.
  • No implants left behind.

Until now there were only two main approaches for treating LSS patients: conservative care and open surgery. Physicians now have a new therapeutic option that reduces pain and increases mobility for their LSS patients by restoring space in the spinal canal. This technologysafely fills the treatment gap while maintaining structural stability.

Used in combination with an epidurogram, mild devices provide maximum patient safety. In addition, complication rates for the mild procedure are lower and recovery times faster than other surgical procedures for treating LSS.

Demonstrating the Vertos Medical commitment to safety and efficacy through solid science, the mild procedure was developed by physicians and engineers with the understanding that in order to gain acceptance, it must be highly effective as well as exceptionally safe and reliable.

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