Minimally Invasive Lumbar Decompression - MILD

Minimally invasive lumbar decompression is primarily a treatment for lumbar spinal stenosis (LSS). Spinal stenosis causes a narrowing of the spinal canal, which then compresses the nerves and causes back pain or Sciatica pain. This procedure is performed in order to relieve some of that pressure and take away or at least reduce the pain. MILD might be considered for those who do not do well under general anesthesia or might not be able to tolerate going through a more invasive open spinal surgery. It is a common procedure and is considered to be very safe. 

Lumbar Spinal Stenosis

Spinal stenosis is specifically the narrowing of the space of the spinal canal, which contains the spinal nerves. It can happen in any part of the spine, but most often occurs in the neck and the lower back. Lumbar Spinal Stenosis is the name for the type of Stenosis that is present in the lower back and the lumbar area is made up of five lumbar vertebrae, which form part of the canal. When this area becomes compressed it will push against the nerves and trigger pain signals to be sent through the central nervous system and into the brain.  

Spinal stenosis is actually, usually the result of a degenerative disease called Osteoarthritis. Both tend to occur in older age, as there is a natural, gradual wear and tear on the body and joints. Osteoarthritis tends to set in around 50 or older and spinal stenosis may follow afterwards. Other causes of spinal stenosis include bone spurs (overgrowth of bone), herniated discs, tumors, and injuries. 

Symptoms of Spinal Stenosis 

While some people may not actually experience any pain associated with spinal stenosis, many will have some sort of symptoms. Symptoms do tend to vary depending on whether the condition is presenting in the cervical spine or lumbar spine.

Symptoms of lumbar spinal stenosis can be: 

-Pain in the lower back. 

-Sciatica pain, which can start in the lower back and often radiates down the legs. Sciatica generally occurs on one side of the body. 

-Numbness or weakness in the legs or feet. 

-Cramping or tingling in the legs or feet. This can occur if you have been standing or walking for long periods of time and will typically dissipate when you sit down or rest your body. 

-Loss of bladder or bowel control. This is an indication of a serious medical issue and needs immediate medical attention. 

The MILD Procedure

Before the procedure begins the patient is brought to the room, where the surgery will be performed, and the area of the back where the pain is located will be cleaned with an antiseptic solution. Local anesthesia will be administered in order to numb the area. X-rays will be used to mark the exact spot where the doctor will be working. 

The patient will be lying face down on the operating table and a small incision will be made. The incision is only about one inch or less and multiple tubes are inserted through the incision in order to open up the space around the muscles and provide access to the spine. A final tube (only the size of a dime or nickel) is inserted so that specialized tools can then be used to correct the problem by removing any excess bone tissue or ligaments that are pressing against the nerves. This will relieve the pressure against the nerve and eliminate or significantly reduce the back pain.  

After the procedure is completed, all of the tools and tube are removed and the small incision is closed and bandaged. The whole process should only take an hour. The patient is then taken to a recovery room to stay for another hour before being discharged.

What Happens Next

When you are ready to go home you will most likely need some pain medication or a muscle relaxer in case of any post-operative pain or muscle spasms you may experience during the healing process (please do not drive or operate heavy machinery if you take any pain medication). Your dressing will be able to be removed a few days to about a week after the procedure. You should also be able to resume normal activities and return to work around this time. However, it is advised to rest and restrict activities to light movements for the first few days or until the area of the procedure has healed completely.  

Even with restricted movement, it is encouraged to move enough to keep the muscles from becoming stiff, but avoid excessive bending and/or twisting. Also, avoid lifting heavy objects until the area is healed. 

Is Minimally Invasive Lumbar Decompression Right for You? 

If you are suffering from chronic back pain, a pain management specialist can help determine the best course of treatment for your individual needs. When other non-surgical treatment methods have not helped, your pain management doctor may recommend minimally invasive lumbar decompression to better provide you with relief. Your specialist will review the benefits of this procedure and any potential risks you may incur. If they decide it is an appropriate treatment they will then advise you on what the necessary steps will be to prepare for and go through with the procedure.

Advantages and Disadvantages of MILD

As with all procedures, there are advantages to a minimally invasive surgery and risks that a person assumes when they agree to it. One of the biggest advantages of MILD is that it’s a minimally invasive procedure, meaning it causes the least amount of trauma to the body and does not create much scar tissue formation. It is significantly easier to heal from, rather than full-on open-spinal surgery, and most people are up and walking again that same day. The procedure is typically completed in an hour or less, as an outpatient, and patients are free to ride home in a car or a plane as soon as they are released (again, usually that same day). With a smaller incision, there is less blood loss and decreased risk for infection. 

While there are several advantages, there is a risk that the procedure will not improve the patient’s pain and may even make it worse. There is also a chance that an infection will occur or some bruising around the area that should clear up within a matter of days. However, these risks are very small and any infections can be treated with an antibiotic. 

How To Get Started

If you would like more information about minimally invasive lumbar decompression or other pain management therapies we offer or our back specialists, please call Pain and Spine Specialists and speak to our dedicated team to improve the quality of your life. You can call Maryland Phones, Pennsylvania Phones, or Virginia Location and schedule an appointment today.