The MILD Procedure Minimally Invasive Lumbar Decompression

Minimally Invasive Lumbar Decompression (MILD) is a cutting-edge procedure designed to alleviate pain and discomfort caused by lumbar spinal stenosis (LSS). Spinal stenosis causes spinal canal narrowing, which then compresses the nerves and causes back or Sciatica pain.

MILD surgery works by removing excess ligament tissue and bone that contribute to the narrowing of the spinal canal. This relieves pressure on the spinal nerves and restores mobility.

Understanding 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 type of Stenosis present in the lower back, and the lumbar area comprises 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 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 afterward. 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 experience any pain associated with spinal stenosis, many will have some symptoms. Symptoms vary depending on whether the condition is present in the cervical or lumbar spine. Symptoms of lumbar spinal stenosis include:

• Pain in the lower back.
• Sciatica pain 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 symptom 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 indicates a serious medical issue that needs immediate medical attention.

The MILD Procedure

Minimally Invasive Lumbar Decompression (aka the M I L D procedure) offers a safer, more efficient, and less disruptive treatment option for patients suffering from lumbar spinal stenosis. Here's a detailed step-by-step explanation of the MILD - decompression of spine surgery:

1. Patient Evaluation and Preparation: A thorough evaluation is conducted to confirm the diagnosis of lumbar spinal stenosis and identify the specific area of the spine requiring treatment. 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 to numb the area, and X-rays will mark the exact spot where our doctors will be working.
2. Accessing the Spine: The patient will lie face down on the operating table, and our doctors will make a small incision will be made (about the size of a baby aspirin) in the lower back. This minimally invasive approach minimizes damage to surrounding tissues and reduces postoperative pain. Multiple tubes are inserted through the incision 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.
3. Visualization and Guidance: Using fluoroscopy, a real-time X-ray imaging technique, our doctors will guide a specialized tube called a cannula through the incision to the targeted area of the spine. This allows for precise visualization of the compressed nerves and the excess ligamentum flavum or bone spurs causing the stenosis.
4. Decompression: Our doctors will insert specialized instruments through the cannula to carefully remove the excess ligamentum flavum and any bone spurs. This decompression enlarges the spinal canal, relieving pressure on the nerves and reducing pain.
5. Closure and Recovery: After the procedure, all tools and tubes are removed, and the small incision is closed and bandaged. The whole process should only take an hour, and the patient is then taken to a recovery room for another hour before being discharged. Since the MILD surgery is performed on an outpatient basis, patients can return home on the same day. Recovery is generally faster than traditional open surgery, with most patients resuming normal activities within a few weeks.

Post Procedure: Recovery Time from MILD procedure

The Minimally Invasive Lumbar Decompression (MILD) procedure offers patients a faster recovery period compared to traditional open surgery for lumbar spinal stenosis. While individual recovery times may vary, the following timeline provides a general overview of what to expect after the MILD procedure:

• Immediate Postoperative Period: Patients are observed for a short time in the recovery area before being discharged. 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).
• First Week: Patients may experience some mild discomfort and swelling around the incision site, which typically subsides within a few days. 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. Your dressing can be removed a few days to a week after the procedure.
• Two to Four Weeks: Most patients can gradually return to their normal daily activities, including work, within two to four weeks following the MILD procedure. However, it is essential to follow your doctor's recommendations and avoid strenuous activities or heavy lifting during this time.
• Six to Eight Weeks: By this point, most patients have made significant progress in their recovery and can resume more vigorous activities, such as exercise and sports, as advised by their healthcare provider.

Tips For A Smooth Recovery

To ensure a smooth and successful recovery after the MILD decompression spinal surgery, consider the following tips:

1. Follow Your Doctor's Instructions: Adhere to your doctor's postoperative care instructions, including wound care, activity restrictions, and any prescribed medications for pain management or inflammation.
2. Attend Follow-Up Appointments: Regular follow-up appointments with our providers are crucial for monitoring your progress and addressing any concerns or complications that may arise.
3. Engage in Gentle Physical Activity: Gradually incorporate light activities, such as walking, into your daily routine to promote healing, increase circulation, and improve flexibility.
4. Participate in Physical Therapy: If recommended by your doctor, participate in physical therapy to strengthen your back muscles, improve mobility, and learn proper body mechanics to prevent future injuries.

Is Minimally Invasive Lumbar Decompression Right for You?

Identifying the ideal candidates for the MILD pain procedure is crucial to ensure the best possible outcomes. 

Pain Symptoms

MILD is best suited for patients experiencing the following symptoms:

Chronic Lower Back and Leg Pain:

Patients suffering from chronic lower back and leg pain that is not relieved by conservative treatments such as physical therapy, medications, or injections may be ideal candidates for MILD.

Limited Mobility:

MILD can be an excellent option for patients whose mobility is significantly impacted due to lumbar spinal stenosis.

No Severe Instability or Deformity:

Patients without severe spinal instability or deformity are better suited for MILD, as the procedure aims to preserve the structural integrity of the spine.

Pain Conditions

MILD is best suited for patients experiencing the following conditions: