Synergy Health Partners

Minimally Invasive Lumbar Decompression (MILD procedure)

What condition does MILD treat?

MILD is a procedure to treat lumbar spinal stenosis. Lumbar spinal stenosis is a common condition in which there is gradual narrowing in the spine causing the nerves to have less space. Lumbar spinal stenosis develops due to age-related degenerative changes and arthritis of the spine. Common symptoms from lumbar spinal stenosis include pain, numbness, or tingling in your lower back, legs or buttocks that limit your ability to stand or walk.

What is the MILD procedure?

The MILD procedure is a minimally invasive (meaning no large incision) technique to debulk the ligamentum flavum that builds up over the years and contributes to the narrowing in spinal stenosis. By debulking the ligamentum flavum, the nerves have more room and receive more blood and oxygen thereby decreasing pain and numbness in lower back and legs. A review of a recent lumbar MRI can determine if you may be a candidate for the MILD.

What is the goal of MILD?

The goal result is to reduce low back pain when standing and walking.  Studies have shown that the majority of patients see improvement in their ability to do daily activities within a few weeks following the procedure.

What are the risks and benefits?

The MILD procedure has similar setup and similar risks to that of lumbar epidural steroid injections.  It is performed under x-ray guidance. As with epidural injections, there is a rare chance of bleeding, infection, and damage to nearby structures. If you are on a blood thinner, we will need to coordinate with your prescribing doctor to safely come off prior to the procedure. Since the procedure is minimally invasive, there is no need for general anesthesia and it is done under IV sedation. There are no implants or permanent hardware from the procedure.

What can I expect?

The MILD procedure typically takes less than an hour and is an outpatient procedure, meaning you go home that same day. Two small incisions, each about the size of a baby aspirin, are made in the area of back to be treated. Soreness around the small incision sites for a few days after the procedure is normal. After a clinic follow-up 7-10 days after the procedure, we will start a specialized physical therapy regimen to help maximize the the benefit and ability stand and walking longer with less pain. Some patients see improvement within 72 hours after the procedure, but most will see improvement within a few weeks of the procedure.

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