Tripler's pain physicians help geriatric patients relieve compressed lumbars

By Stephanie Bryant, Tripler Army Medical Center Public AffairsMarch 16, 2012

TRIPLER ARMY MEDICAL CENTER, Hawaii " The Department of Integrative Pain Management, here, completed the first minimally invasive lumbar decompression in Hawaii, Jan. 20.

Maj. Brian McLean, chief, Pain Medicine and Interventional Pain Services, Tripler Army Medical Center, said the MILD procedure is for a very specific person; those with lumbar spinal stenosis who are not candidates for open surgery.

"(Our typical patient is) a person who either does not want an open surgery or is too sick or too old to undergo the anesthesia for an open surgery," McLean explained.

According to McLean, lumbar spinal stenosis is a narrowing of the lower spinal canal, which may cause pain and numbness that limit a person's ability to walk or stand. It is usually found in people over 50 years of age.

The traditional procedure to treat LSS calls for 2-4 inch incision and cut away the bone and ligaments causing the pressure. McLean said the state-of-the-art MILD procedure is done with light sedation instead of general anesthesia and does not require sutures, instead utilizing derma bond, or skin glue, to close the puncture sites.

"Patients are able get up and walk and move the next day," McLean said.

McLean said the safety studies on the procedure not only show that there is a lower risk of bleeding, complications and infections, but the patients feel better within a few days, reducing recovery times and hospital stays.

Tripler's Dr. Phillip Lim, pain management physician, is one of four physicians at TAMC trained to perform the surgery and was the first doctor in Hawaii to perform the procedure.

"It's always nice to be the first one to do something, but, more importantly, it allows us to be able to offer more (treatment options) to the patients," Lim explained. "We want to offer them more chances at getting better."

Lim said the procedure is a good addition to the many treatments that the IPM department offer s because it is an innovative technique that provides a minimally invasive surgical option in a population of patients who may not have had any other option before.

"At the end of the day, it's all about function and quality of life," Lim added. "Can you imagine something as simple as the MILD procedure to make it able for (patients) to go for a walk without pain?"