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Lumbar Spinal Stenosis & Mild® Lumbar Spinal Stenosis & mild® By Brian D. Klagges, MD, Elliot Pain Management Center he most common indication for This new, minimally invasive Tsurgery in persons aged over procedure provides an alternative 60 in the United States is lumbar decompression treatment that can spinal stenosis (LSS). LSS is a increase mobility and significantly condition due to narrowing of the reduce the pain and numbness spinal cord causing nerve pinching associated with LSS while offering which leads to persistent pain in the potential for a shorter the buttocks, limping, lack of operation and faster recovery time. feeling in the lower extremities, and Patients generally go home the decreased physical activity. More same day as the procedure. Mild specifically, there are several different safely fills the treatment gap between forms of lumbar spinal stenosis. conservative therapy and major surgery The most common is degenerative while maintaining structural stability of the stenosis, occurring in virtually the entire adult spine. Used in combination with an epidurogram population as a result of the natural process of aging. It is a (dye placed in the epidural space), mild devices provide degenerative narrowing of the spinal canal caused by bone and/or maximum patient safety. In addition, complication rates for the ligament hypertrophy in local, segmental or generalized regions. mild procedure are lower and recovery times faster than other The narrowing results in compression of spinal nerves and nerve surgical procedures for treating LSS. roots, causing a constellation of symptoms, including lower back The physicians at the Elliot Hospital’s Pain Management Center pain and/or lower extremity pain, as well as weakness. are the first and, as of this writing, the only physicians in the State Currently, it is estimated that as many as 400,000 Americans, most of New Hampshire to offer this innovative new procedure. over the age of 60, may already be suffering from the symptoms of lumbar spinal stenosis and this number is expected to grow as Dr. Klagges, Medical Director of the Pain Management members of the baby boom generation begin to reach their 60s over Center, joined the center in 2007 after completing the next decade. training at Tufts Medical School’s flagship teaching Until now there were only two main approaches for treating LSS hospitals. He initially trained in General Surgery at the patients: conservative care and open surgery. Physicians now have a Tufts Medical Center, and completed both Anesthesiology new therapeutic option that reduces pain and increases mobility for residency and an Interventional Pain Management their LSS patients by restoring space in the spinal canal. fellowship at the Caritas-St. Elizabeth’s Medical Center of Boston. During training, he was awarded the Robelen The mild procedure (mild is an acronym for minimally invasive Award for the most outstanding resident in anesthesiology, and the Levesque lumbar decompression) is a safe, therapeutic alternative for treating Award in Pain Management. Dr. Klagges received his undergraduate degree LSS and can be performed under local anesthesia (usually with from Providence College, Providence, RI and graduated with research honors sedation). from the State University of New York At Buffalo School of Medicine. He is a The specialized mild devices (marketed and manufactured by Diplomate of the American Board of Anesthesiology, and has subspecialty Vertos Medical Inc., Aliso Viejo, CA) are used under fluoroscopic certification in Pain Management. Dr. Klagges’ areas of interest include (x-ray) guidance to remove tissue and bone that compress nerves in advanced neuromodulatory techniques and minimally invasive therapies for and around the spinal cord, causing pain and restricting mobility. the treatment of back pain. 185 Queen City Avenue | Manchester, NH 03101 | 603-663-5300 | www.elliothospital.org.
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