Minimally Invasive Procedures for Central and Neuroforaminal Spinal Stenosis

Dr. Steve Aydin reflects on the evolution of minimally invasive treatments for lumbar spinal stenosis, questioning whether these procedures truly change patient outcomes or mainly improve symptoms. He compares options like MILD (percutaneous lumbar decompression) and interspinous devices (Vertiflex, Minuteman), noting that while imaging rarely shows significant post-procedure change, patients often experience relief. The talk highlights challenges in patient selection, balancing risks like facet pain after spacers, and the importance of individualized algorithms for central versus foraminal stenosis. Aiden emphasizes adaptability as techniques evolve, aiming for the least invasive intervention with meaningful symptom improvement over aggressive surgical alternatives.