The Mild Procedure

A mild (minimally invasive lumbar decompression) procedure involves removing a segment of thickened ligament in the spine. A thickened ligament is a cause, or common contributor, to lumbar spinal stenosis – or spinal canal narrowing. Removing the thickened ligament reduces the narrowing and relieves the associated symptoms.

Who is a candidate for mild?

Candidates for a mild procedure include patients with lumbar spinal stenosis, related to a thickened ligamentum flavum (spinal ligament), who are experiencing symptoms.

What are the symptoms of lumbar spinal stenosis?

Symptoms of lumbar spinal stenosis include pain in the back and/or legs that worsens with standing and walking. This pain or discomfort is often believed by sitting, leaning forward, such as when pushing a shopping cart, or when lying in the fetal position. Alternatively, lumbar spinal stenosis symptoms may not involve pain, but instead a weakness, heaviness, or tingling that requires sitting or lying down for relief.

What are the causes of lumbar spinal stenosis?

Spinal stenosis is caused by degeneration of structures within the spine, which places pressure on the spinal nerves. Wear and tear is often caused by the aging process; degeneration causes increased size of supporting spinal structures. Degeneration of the ligamentum flavum, discs, and bony overgrowths of the spinal column often work together to produce spinal stenosis, or a narrowed spinal canal.

What are the most common treatments for lumbar spinal stenosis?

Conservative treatments for lumbar spinal stenosis include physical therapy, pain medication, and lumbar epidural steroid injections. Permanent treatments include indirect (using an inter-spinous spacer) or direct decompression (open back surgery) depending on the severity of stenosis. The mild procedure provides long-term relief without an implant or major back surgery and preserves the option for additional more invasive treatment later on, if needed.

How is the procedure performed?

You will be positioned on your stomach on the procedure table. The lower back will be cleaned and numbed with local anesthetic; you will also receive IV anesthesia by an anesthetist. Your surgeon will use fluoroscopy (or X-ray guidance) to confirm the precise location. Through a tiny incision, your surgeon will use instruments to remove small pieces of the ligament, increasing space in the spinal canal and relieving pressure.

What are the risks associated with the mild procedure?

This procedure is generally very safe and effective. As with all procedures there are some risks, including infection, inadequate pain relief, bleeding, and increased pain for a few days after the procedure.