The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis

Nagy A Mekhail,1 Shrif J Costandi,1 Sherif Armanyous,1 Ricardo Vallejo,2 Lawrence R Poree,3 Lora L Brown,4 Stanley Golovac,5 Timothy R Deer6 1Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, OH, USA; 2Millennium Pain Center, Bloomington, IL, USA; 3Pain Management Center, UCSF He...

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Autores principales:	Mekhail NA, Costandi SJ, Armanyous S, Vallejo R, Poree LR, Brown LL, Golovac S, Deer TR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	mild neurogenic claudication ligamentum flavum lss Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/ea556a3519354bfebc3b12436ba0079d
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spelling	oai:doaj.org-article:ea556a3519354bfebc3b12436ba0079d2021-12-02T10:12:26ZThe Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis1179-1470https://doaj.org/article/ea556a3519354bfebc3b12436ba0079d2020-06-01T00:00:00Zhttps://www.dovepress.com/the-impact-of-age-on-the-outcomes-of-minimally-invasive-lumbar-decompr-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Nagy A Mekhail,1 Shrif J Costandi,1 Sherif Armanyous,1 Ricardo Vallejo,2 Lawrence R Poree,3 Lora L Brown,4 Stanley Golovac,5 Timothy R Deer6 1Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, OH, USA; 2Millennium Pain Center, Bloomington, IL, USA; 3Pain Management Center, UCSF Health, San Francisco, CA, USA; 4TruWell Health, St. Petersburg, FL, USA; 5Florida Pain Institute, Merritt Island, FL, USA; 6Center for Pain Relief, Charleston, WV, USACorrespondence: Nagy A Mekhail Email mekhain@ccf.orgBackground and Purpose: Minimally invasive lumbar decompression (mild®) is an effective long-term therapy for patients with symptomatic lumbar spinal stenosis (LSS) resulting primarily from hypertrophic ligamentum flavum (HLF). Most subjects in clinical studies of the mild procedure have been older adults (age≥ 65). While the incidence of LSS increases with age, a substantial number of adults (age< 65) also suffer from neurogenic claudication secondary to HLF. In this report, outcomes of mild were compared between adults and older adults.Patients and Methods: All prospective studies of the mild procedure with a 1-year follow-up completed since the beginning of 2012 that allowed the inclusion of adult patients of all ages were reviewed. Outcomes of visual analog scale (VAS), Oswestry Disability Index (ODI), Pain Disability Index (PDI), Roland Morris Low Back Pain and Disability Questionnaire (RMQ), standing time and walking distance were compared for adults and older adults.Results: Four studies met the inclusion criteria, resulting in an analysis of 49 adults and 160 older adults. Patients in both age groups experienced significant mean improvements in all but one outcome measure at 6- and 12-month follow-up. Differences between the two age groups in all scores at 6 and 12 months were not statistically significant.Conclusion: Analysis of the four studies indicated that symptom improvements for adults and older adults were significant from baseline, and no statistically significant difference was observed between the two age groups. These results illustrate that mild can be an effective treatment for LSS due primarily to HLF, regardless of the adult patient age.Keywords: mild, neurogenic claudication, ligamentum flavum, LSSMekhail NACostandi SJArmanyous SVallejo RPoree LRBrown LLGolovac SDeer TRDove Medical Pressarticlemildneurogenic claudicationligamentum flavumlssMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 13, Pp 151-161 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	mild neurogenic claudication ligamentum flavum lss Medical technology R855-855.5
spellingShingle	mild neurogenic claudication ligamentum flavum lss Medical technology R855-855.5 Mekhail NA Costandi SJ Armanyous S Vallejo R Poree LR Brown LL Golovac S Deer TR The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis
description	Nagy A Mekhail,1 Shrif J Costandi,1 Sherif Armanyous,1 Ricardo Vallejo,2 Lawrence R Poree,3 Lora L Brown,4 Stanley Golovac,5 Timothy R Deer6 1Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, OH, USA; 2Millennium Pain Center, Bloomington, IL, USA; 3Pain Management Center, UCSF Health, San Francisco, CA, USA; 4TruWell Health, St. Petersburg, FL, USA; 5Florida Pain Institute, Merritt Island, FL, USA; 6Center for Pain Relief, Charleston, WV, USACorrespondence: Nagy A Mekhail Email mekhain@ccf.orgBackground and Purpose: Minimally invasive lumbar decompression (mild®) is an effective long-term therapy for patients with symptomatic lumbar spinal stenosis (LSS) resulting primarily from hypertrophic ligamentum flavum (HLF). Most subjects in clinical studies of the mild procedure have been older adults (age≥ 65). While the incidence of LSS increases with age, a substantial number of adults (age< 65) also suffer from neurogenic claudication secondary to HLF. In this report, outcomes of mild were compared between adults and older adults.Patients and Methods: All prospective studies of the mild procedure with a 1-year follow-up completed since the beginning of 2012 that allowed the inclusion of adult patients of all ages were reviewed. Outcomes of visual analog scale (VAS), Oswestry Disability Index (ODI), Pain Disability Index (PDI), Roland Morris Low Back Pain and Disability Questionnaire (RMQ), standing time and walking distance were compared for adults and older adults.Results: Four studies met the inclusion criteria, resulting in an analysis of 49 adults and 160 older adults. Patients in both age groups experienced significant mean improvements in all but one outcome measure at 6- and 12-month follow-up. Differences between the two age groups in all scores at 6 and 12 months were not statistically significant.Conclusion: Analysis of the four studies indicated that symptom improvements for adults and older adults were significant from baseline, and no statistically significant difference was observed between the two age groups. These results illustrate that mild can be an effective treatment for LSS due primarily to HLF, regardless of the adult patient age.Keywords: mild, neurogenic claudication, ligamentum flavum, LSS
format	article
author	Mekhail NA Costandi SJ Armanyous S Vallejo R Poree LR Brown LL Golovac S Deer TR
author_facet	Mekhail NA Costandi SJ Armanyous S Vallejo R Poree LR Brown LL Golovac S Deer TR
author_sort	Mekhail NA
title	The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis
title_short	The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis
title_full	The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis
title_fullStr	The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis
title_full_unstemmed	The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis
title_sort	impact of age on the outcomes of minimally invasive lumbar decompression for lumbar spinal stenosis
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/ea556a3519354bfebc3b12436ba0079d
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The Impact of Age on the Outcomes of Minimally Invasive Lumbar Decompression for Lumbar Spinal Stenosis

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