Decrease in health care resource utilization with MILD.

OBJECTIVE: To compare health care resource utilization before and after minimally invasive lumbar decompression (MILD) procedure. DESIGN: Case series. SETTING: Veteran's Administration health care system. SUBJECTS: All patients who underwent MILD at the author's institution. METHODS: The charts of 22 patients who underwent MILD procedure were reviewed. The primary comparison was between the amount of time spent in specialty care and the number of interventional procedures performed before and after MILD. Each patient's current status and need for continued specialty care were secondary measures. Patient satisfaction with MILD, and pre- and post-VAS were recorded as well. RESULTS: After MILD, there was close to 45% reduction in time spent in specialty care and an almost fourfold decrease in number of interventional pain procedures performed on patients with lumbar spinal stenosis (LSS). Over half the patients no longer required chronic pain management to treat their LSS symptoms. CONCLUSIONS: Not only is MILD a reliable method to treat LSS, MILD also appears to reduce the consumption of limited health care resources.

Vibratory and perceptual measurement of resonant voice.

PURPOSE: This study set out to investigate whether there existed a correlation between auditory-perceptual judgment of resonant voice and the physical vibration in the facial bone. The magnitude of bone vibration in the facial bone during different types of voice production (resonant vs nonresonant vs strained voices) was also investigated. METHOD: Thirty-six healthy normal subjects produced three types of phonations: resonant voice, habitual nonresonant voice, and strained voice. A piezoelectric accelerometer was used to measure the vibrations in the nasal bridge and the perilaryngeal area during the phonation. Seventy-two selected nasal sounds (/ma/) produced under the resonant voice condition by these speakers were rated by two experienced speech pathologists on the magnitude of auditory-perceptual resonance using an 11-point equal-appearing interval scale. The magnitude of bone vibration was also compared across the three voice types. RESULTS: Significant moderate correlations were found between the physical bone vibration and the auditory-perceptual rating of resonant voice at the nasal bridge of the facial bone (0.6). Resonant voice, compared with the strained and nonresonant voice types, was also found to have a significant increase in the magnitude of facial bone vibration. Nasal stimuli, compared with nonnasal stimuli, facilitated greater bone vibration during resonant voice production. CONCLUSION: Piezoelectric accelerometer, as an objective quantitative tool, measures reliably the extent of bone vibration in resonant voice phonation. It is a useful tool for determining the bone vibration in relation to resonant voice.