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CLINICAL EVIDENCE

Science-driven innovation

Quality scientific research proves what works in endoscopic spine surgery through objective data and clinical transparency.

Featured Studies

No Anatomical Improvement with MILD Procedure

Preoperative versus Postoperative MRI Comparisons After the MILD Procedure vs Open Decompression for Lumbar Spinal Stenosis: Multicenter Cohort Study

Mark R Jones, MD*, Luis M Fandos, MD, Jonathan S. Daitch, MD, Sandra Thompson, MD, Douglas P Beall, MD, Ajay Yeddu, MD, Paul Pannozzo, MD, Rajmani Krishnan MD, Sunil D Albert, MD, Daniel J Kohane, MD, Yeshvant A Navalgund, MD, Hasan Abed, MD, Soubrata V Raikar MD, Erik Spayde, MD, William M Costigan, MD, Vito Lore, PE, Matthew Lazzari, HS, Sukanya Chebrolu, MS, Hope Estevez, HS, Chukwunonso C Ilogu, MD, Jason A Seale, MBBS, Kingsley R. Chin, MD. Spine J. 2026.

Conclusion

The MILD procedure did not produce anatomical decompression or SedSign reversal on MRI, whereas open decompression reliably achieved both. Secondary anatomical changes, such as scar tissue and muscle signal alterations, were observed only in theopen surgery group. These findings suggest that while MILD is tissue-sparing, it may be insufficient for achieving anatomical goals in patients with central LSS.

Clinically Significant Outcomes with Decompression

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J Orthop. 2020 Aug 7;21:375–378.

Experience of using a 3-blade LES-Tri retractor over 5 years for lumbar decompression microdiscectomy

Chin KR, Pencle FJR, Seale JA, Pencle FK. 

Pain relief

Patients undergoing decompression experienced a ~68% reduction in pain scores (VAS).

Functional improvement

Disability scores (ODI) improved by ~44% following decompression.

Clinically Significant Outcomes with Microdiscectomy

J Spinal Disord Tech. 2006 Jun;19(4):257–261.

Prospective evaluation of a 3-blade speculum cannula for minimally invasive lumbar microdiscectomy

Chin KR, Michener TA. J Spinal Disord Tech. 2006 Jun;19(4):257–261.

Pain relief

Patients undergoing microdiscectomy experienced a ~96% reduction in leg pain (VAS), with scores improving from 8.0 to 0.3, reflecting near-complete symptom resolution.

High success rate

96% of patients achieved complete resolution of radicular leg pain following the procedure.

technical note & case illustrations 

Endoscopic LESS Invasive Decompression (ELID): A Fluoroscopy-Guided Technique for Central, Foraminal, and Lateral Recess Decompression

Kingsley R. Chin MD, Julian Cameron MD, Sandra Thompson MD, Jonathan Daitch MD, Keith Javery MD, Sachin Narain MD, Vito Lore PE, Erik Spayde MD, Hope Estevez HS, Sukanya Chebrolu MS, Jason A. Seale MBBS

Technical Note

ELID-DX Endoscopic Discectomy One-Third, Two-Thirds Rule to Successfully Access a Herniated Disc Through an Extraforaminal Approach

Kingsley R. Chin MD, Julian Cameron MD, Sandra Thompson MD, Jonathan Daitch MD, Keith Javery MD, Sachin Narain MD, Vito Lore PE, Erik Spayde MD, Hope Estevez HS, Sukanya Chebrolu MS, Jason A. Seale MBBS

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