If You Have Lumbar Spinal Stenosis, There’s an Exciting New Option

The mild® procedure is minimally invasive and effective

If you’ve struggled with lumbar spinal stenosis (LSS), you know it can impact your life. People with severe LSS often can’t stand longer than a few minutes or walk more than a few hundred feet without feeling severe pain.

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Bulging disk and/or enlargement of the ligaments in your spine can cause LSS. When the spinal canal narrows, it causes nerve compression. When someone with LSS stands or walks, the spinal canal narrows even more, causing low back and leg pain that is relieved with sitting or bending forward.

Until a few years ago, the only treatment options available were either of two extremes: conservative therapies or open spine surgery.

Weighing treatment options for LSS

However, conservative treatments, such as NSAIDS, physical therapy and epidural steroid injections, only work for a fraction of people. Also, when they do work, the effect is often not sustained and requires repeated treatments.

Open spine surgery, on the other hand, works to relieve pressure on spinal nerves, but surgery and anesthesia may carry increased risk in older patients.

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Now, there’s a new outpatient option called mild®, which stands for minimally invasive lumbar decompression. It is only an option for patients who have significant LSS due to thickening of the ligamentum flavum, or ligaments of the spine.

How the mild procedure helps

In this procedure, a surgeon uses a special tool that glides through a very small portal between the bones. Guided by an X-ray and contrast that is injected during the procedure, the surgeon scrapes out the ligament and widens the spinal canal to reduce nerve roots compression.

“The mild procedure relieves pain and increases mobility, all while maintaining the structural integrity of the spine,” says Nagy Mekhail, MD, PhD, Director of Evidence-Based Medicine in the Department of Pain Management at Cleveland Clinic.

“The bony architecture of the spine remains intact and the spinal mechanics are not disrupted so patients typically recover quickly,” he says.

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People generally go home a couple of hours after the procedure and they can begin rehabilitation. Usually, this involves walking regularly and/or participate in physical therapy after the procedure.

Results of the mild procedure

Dr. Mekhail says results have been positive, including:

  • No major complications related to the device or procedure at one-year follow-up.
  • Patients are able to walk and stand for longer periods of time.
  • Less numbness, tingling and muscle weakness commonly associated with LSS.

“It is a great option for the right patients,” says Dr. Mekhail. “Those who have the procedure are able to get back to more normal living and to the activities they enjoy very quickly.”

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