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MILD Procedure

Minimally invasive lumbar decompression for spinal stenosis


Spinal Stenosis:

Spinal stenosis is a common medical disorder of aging adults. It can result from a herniated disc, forward slippage of the vertebrae, thickening of the ligamentum flavum, and arthritis of the facet joints. These changes in the spinal tunnel resulting narrowing therefore there is less space for the nerves and spinal cord to go through.  

In patients with spinal stenosis, the main complaint is the limited ability of walking and stand. These activities would result in pain, numbness, tingling that get radiate down one or both legs and often gets better when the patient stoops over the shopping cart or sits down. In more significant cases, patients are only able to walk for less than a block before they have to sit and relieve the symptoms. Even simple household activities and preparing a meal in the kitchen that require standing may become difficult. 

Traditional treatments have been physical therapy, epidural injections, and spine surgery. Technology has advanced and now we have two options for spinal stenosis, including MILD Procedure and Vertiflex implant that could be attempted before open surgery. These are minimally invasive interventions performed in a day surgical setting, under conscious sedation (no intubation, only iv sedatives), and can result in substantial improvement of leg pain, numbness, tingling, and as a result, improved function.

MILD Procedure:

This is an x-ray guided lumbar decompression. It is indicated for moderately severe lumbar spinal stenosis. The typical candidates will have difficulty with standing and walking and would often require sitting to relieve leg pain.

MILD Procedure takes 30-40 minutes to perform in an ambulatory day surgery setting. The patient is not intubated and only IV sedation by an anesthesiologist is used. There is no overnight stay, and the patient will go home an hour after the Procedure. This type of anesthesia is common in colonoscopy and small procedures.

Once the patient is sedated, skin is anesthetized. Following this, MILD procedure tools are used to remove a small amount of degenerated and thickened ligament (ligamentum flavum) to make more room for the nerves to pass through. The incision which is made is the size of the baby aspirin. Incision is covered by Steri-Strip (or a single stich) and a bandage is applied, and the patient will be discharged home about an hour after the Procedure.


After the MILD Procedure, all patients are asked to exercise and walk on the very next day. The patient will track the progress in terms of pain relief and improvement of their ability to stand and walk for 12 weeks after the Procedure.
The MILD Procedure is more effective for leg symptoms than is it for back pain. The effect of the MILD Procedure is often notable somewhere between 6 to 12 months after the treatment.   Improvements may continue for several months after the treatment.

At our spine center, we have treated patients from 60-94  years of age with MILD Procedure. This is an FDA approved treatment. This is a Medicare-covered procedure, but some co-pays, deductibles, and facility charges may apply. 

To learn more about this Procedure or to see if you are a candidate for the MILD Procedure, don't hesitate to get in touch with us

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