Minimally Invasive Lumbar Decompression (MILD): A Breakthrough in Treating Lumbar Stenosis

Understanding Lumbar Stenosis

Lumbar stenosis refers to the narrowing of the spinal canal in the lower back, resulting in compression of the spinal cord or nerves. This compression often leads to pain, weakness, numbness, and reduced mobility. Traditional treatments for lumbar stenosis include physical therapy, pain management, and, in severe cases, open surgery. However, MILD has emerged as an alternative that offers promising outcomes with fewer complications.

MILD Procedure Description

MILD is a minimally invasive procedure designed to relieve the symptoms of lumbar stenosis without the need for extensive surgery. This outpatient procedure typically involves the following steps:

• Sedation Anesthesia: Patients receive mild sedation anesthesia to numb the affected area.
• Guided Imaging: Using fluoroscopy or other imaging techniques, the surgeon guides a small tube or catheter into the affected area of the spine.
• Tissue Removal: Once in position, the surgeon removes excess bone and tissue that contribute to the narrowing of the spinal canal. This process is similar to drilling away a small portion of bone to create more space for the spinal cord and nerves.
• Debulking of Ligament Flavum: The surgeon will then remove portions of the ligament flavum, a tissue that often causes compression in lumbar stenosis cases.
• Recovery: Patients can typically return home on the same day as the procedure.

Indications for the MILD Procedure

MILD is suitable for patients who experience the following:

• Lumbar Stenosis: The primary indication for MILD is lumbar stenosis, especially in patients who haven't responded to conservative treatments.
• Neurogenic Claudication: Patients who experience neurogenic claudication, a symptom of lumbar stenosis characterized by leg pain when walking or standing, may benefit from the MILD procedure.
• Age and Health Status: While MILD is not limited to older patients, it is often considered for individuals who are not good candidates for open surgery due to age or underlying health conditions.

Candidates for the MILD procedure should consult with their healthcare provider to determine its suitability for their specific case.

Success Rates of MILD

The success rates of the MILD procedure are encouraging. A study published in the "Journal of Neurosurgery: Spine" in 2016 by Marcy C. Gertner et al., titled "Minimally Invasive Lumbar Decompression for Spinal Stenosis," reported that MILD resulted in a significant reduction in pain and improvement in walking distance for patients with lumbar stenosis. Another study published in "Pain Physician" in 2014 by Peter S. Staats et al., titled "MILD® is an Effective Treatment for Lumbar Spinal Stenosis with Neurogenic Claudication: MiDAS ENCORE Randomized Controlled Trial," showed that the MILD procedure provides sustained pain relief and functional improvement for patients over a two-year follow-up period.

These studies, among others, suggest that MILD is a viable and successful option for treating lumbar stenosis, with minimal complications and a shorter recovery period compared to traditional open surgery.

Conclusion

The Minimally Invasive Lumbar Decompression (MILD) procedure offers new hope for individuals suffering from lumbar stenosis. With a minimally invasive approach, MILD provides effective relief from pain, improved mobility, and a quicker recovery. The procedure is best suited for those who have not responded to conservative treatments and are not good candidates for extensive open surgery. The medical literature supports its effectiveness, making MILD a promising option for those seeking relief from lumbar stenosis symptoms.

Apollo Pain Management is proud to offer this state-of-the-art procedure to our patients. Ask your APM physician if the MILD procedure is right for you.

Author

R James Warren, MD MS Me