Minimally Invasive Lumbar Decompression
What is the MILD® Procedure?
Minimally invasive lumbar decompression or mild® is a procedure developed by Vertos Medical to treat lumbar spinal stenosis by relieving pressure on the spinal nerves.
What is Lumbar Spinal Stenosis?
Lumbar spinal stenosis is a degenerative disease that usually occurs after the age of 50. It causes narrowing of the lumbar spinal canal and compression of the spinal nerves. This can occur due to overgrowth of the vertebral joints and ligaments or bulging of a vertebral disc.
Lumbar spinal stenosis can result in:
- Pain in the leg, buttock and groin region
- Weakness, stiffness, cramping or numbness in the legs and buttocks
Those with lumbar spinal stenosis have difficulty walking or standing, but get relief on sitting down, which causes flexion of the spine.
Benefits of the MILD® Procedure
Mild cases of lumbar spinal stenosis may be treated by conservative therapy. Severe cases are usually treated by a procedure called laminectomy, which involves removal of the laminar bone, which overlies the back of the spinal cord. The mild® procedure overcomes the drawbacks of a regular laminectomy, which includes a larger incision, tissue trauma, scarring, and spinal instability.
Who is an Ideal Candidate for the MILD® Procedure?
The MILD® procedure is ideal in the following cases:
- You have not got adequate relief from conservative treatments including rest, medications, physical therapy or steroid injections
- You do not wish to undergo invasive spine surgery or it is not recommended due to health reasons
What does the MILD® Procedure Involve?
The procedure is performed in an outpatient setting. You will receive sedation and local anesthesia for your comfort. The site of stenosis is previously identified with the help of an MRI or CT scan.
You will lie face down for the procedure. A thin portal is inserted through the skin of the back of the spine with the help of a trocar and guided to the appropriate surgical site under fluoroscopy (live X-ray imaging). Specially designed instruments inserted through the portal are used to carry out the procedure. Part of the laminar bone at the site of stenosis is removed (laminotomy). The ligament flavum, which supports the laminar bone, is partly excised along with fatty tissue. This relieves pressure on the spinal nerves with minimal trauma to the surrounding tissues. Imaging studies are used to verify decompression of the spinal canal. The portal is then removed and the skin closed with a bandage.
Recovery Following the MILD® Procedure
Following the procedure, you will be taken to the recovery room where you are observed for about 2 hours. You will then be allowed to walk and may be discharged to home. Following this, a gradual advance in activities is recommended.
Follow this link to read Dr Hiratzka’s article reviewing MILD as well as other minimally invasive spine procedures