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Minimally Invasive Lumbar Decompression and Interspinous Process Device for the Management of Symptomatic Lumbar Spinal Stenosis: a Literature Review

  • Other Pain (AD Kaye and N Vadivelu, Section Editors)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Symptomatic lumbar spinal stenosis (LSS) is a condition affecting a growing number of individuals resulting in significant disability and pain. Traditionally, treatment options have consisted of conservative measures such as physical therapy, medication management, epidural injections and percutaneous adhesiolysis, or surgery. There exists a treatment gap for patients failing conservative measures who are not candidates for surgery. Minimally invasive lumbar decompression (MILD®) and interspinous process device (IPD) with Superion® represent minimally invasive novel treatment options that may help fill this gap in management. We performed a literature review to separately evaluate these procedures and assess the effectiveness and safety.

Recent Findings

The available evidence for MILD and Superion has been continuously debated. Overall, it is considered that while the procedures are safe, there is only modest evidence for effectiveness.

Summary

For both procedures, we have reviewed 13 studies. Based on the available evidence, MILD and Superion are safe and modestly effective minimally invasive procedures for patients with symptomatic LSS. It is our recommendation that these procedures may be incorporated as part of the continuum of treatment options for patients meeting clinical criteria.

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Acknowledgments

David Lee Osterbur, PhD, MLIS

Director of Entrepreneurial Ventures & Director of Harvard Library of Evidence

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Authors and Affiliations

  1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA

    Justin Merkow, Richard D. Urman & R. Jason Yong

  2. Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO, USA

    Narayana Varhabhatla

  3. Pain Management Centers of America, Paducah, KY, USA

    Laxmaiah Manchikanti

  4. Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA, USA

    Alan D. Kaye

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  1. Justin Merkow
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Correspondence to Richard D. Urman.

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Justin Merkow, Narayana Varhabhatla, Laxmaiah Manchikanti, Richard D. Urman and Jason Yong declare no conflict of interest. Alan Kaye is a Section Editor for Current Headache and Pain Reports. He has not been involved in the editorial handling of this manuscript. Dr. Kaye is also a speaker for Merck.

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Merkow, J., Varhabhatla, N., Manchikanti, L. et al. Minimally Invasive Lumbar Decompression and Interspinous Process Device for the Management of Symptomatic Lumbar Spinal Stenosis: a Literature Review. Curr Pain Headache Rep 24, 13 (2020). https://doi.org/10.1007/s11916-020-0845-2

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