{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:47:20Z","timestamp":1786549640458,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,5,30]],"date-time":"2023-05-30T00:00:00Z","timestamp":1685404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This prospective longitudinal study compares outcomes between Medicare beneficiaries receiving percutaneous image\u2010guided lumbar decompression (PILD) using the <jats:italic>mild<\/jats:italic>\u00ae procedure and a control group of patients receiving interspinous spacers for the treatment of lumbar spinal stenosis (LSS) with neurogenic claudication (NC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients diagnosed with LSS with NC and treated with either the <jats:italic>mild<\/jats:italic> procedure or a spacer were identified in the Medicare claims database. The incidence of harms, the rate of subsequent interventions, and the overall combined rate of harms and subsequent interventions during 2\u2010year follow\u2010up after the index procedure were compared between the two groups and assessed for statistical significance with <jats:italic>p<\/jats:italic>\u2009=\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 2229 patients in the <jats:italic>mild<\/jats:italic> group and 3401 patients who were implanted with interspinous spacers. The rate of harms for those treated with the <jats:italic>mild<\/jats:italic> procedure was less than half that of patients implanted with a spacer (5.6% vs. 12.1%, respectively; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) during 2\u2010year follow\u2010up. The rate of subsequent interventions was not significantly different between the two groups (24.9% and 26.1% for the <jats:italic>mild<\/jats:italic> and spacer groups, respectively; <jats:italic>p<\/jats:italic>\u2009=\u20090.7679). The total rate of harms and subsequent interventions for <jats:italic>mild<\/jats:italic> was found to be noninferior to spacers (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This comprehensive study of real\u2010world Medicare claims data demonstrated a significantly lower rate of harms for the <jats:italic>mild<\/jats:italic> procedure compared to interspinous spacers for patients diagnosed with LSS with NC, and a similar rate of subsequent interventions during 2\u2010year follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.13256","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T05:41:15Z","timestamp":1685511675000},"page":"776-784","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Percutaneous image\u2010guided lumbar decompression and interspinous spacers for the treatment of lumbar spinal stenosis: A 2\u2010year Medicare Claims Benchmark Study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4079-5165","authenticated-orcid":false,"given":"Peter S.","family":"Staats","sequence":"first","affiliation":[{"name":"National Spine and Pain Centers  Atlantic Beach Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1039-8166","authenticated-orcid":false,"given":"Jonathan M.","family":"Hagedorn","sequence":"additional","affiliation":[{"name":"iSpine Pain Physicians  Maple Grove Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5833-0297","authenticated-orcid":false,"given":"David E.","family":"Reece","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9489-2550","authenticated-orcid":false,"given":"Natalie H.","family":"Strand","sequence":"additional","affiliation":[{"name":"Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9937-2864","authenticated-orcid":false,"given":"Lawrence","family":"Poree","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Perioperative Care, UCSF Pain Management Center University of California at San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnac028"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2012.00574.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2021-0056"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0097142"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650\u2010199801000\u201000004"},{"issue":"7","key":"e_1_2_9_7_1","first-page":"789","article-title":"Long\u2010term safety and efficacy of minimally invasive lumbar decompression procedure for the treatment of lumbar spinal stenosis with neurogenic claudication: 2\u2010year results of MiDAS ENCORE","volume":"43","author":"Staats PS","year":"2018","journal-title":"Reg Anesth Pain 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Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papr.13256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T02:56:48Z","timestamp":1697770608000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/papr.13256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,30]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/papr.13256"],"URL":"https:\/\/doi.org\/10.1111\/papr.13256","archive":["Portico"],"relation":{},"ISSN":["1530-7085","1533-2500"],"issn-type":[{"value":"1530-7085","type":"print"},{"value":"1533-2500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,30]]},"assertion":[{"value":"2022-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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