MILD: Minimally Invasive Lumbar Decompression

Spinal Stenosis, the closing of the spinal column, is an extremely common condition which develops as we get older. It is by definition narrowing of the spinal canal. The spinal structures, which include the vertebral bodies, intervertebral disks, and facet joints degenerate as they get older.  As this occurs they collapse downward and inward towards the spinal cord.  Additional degeneration and hypertrophy (swelling) of supporting structures, including the ligamentum flavum (which is accessory supporting tissue within the spinal column) can exacerbate this condition.  This results in a condition called neurogenic claudication.

The symptoms of neurogenic claudication may involve the lower back, lower extremities, or both.  It can include back pain or numbness that occurs when standing upright, but alleviated upon sitting or bending forward.  It also can produce pain, numbness or tingling in the buttocks and legs which occurs upon walking and is alleviated by rest.  Traditionally, if conservative treatment including epidural steroid injections are not beneficial, a multilevel open lumbar laminectomy is the only treatment option.

And alternative treatment option is now available. This is the minimally invasive lumbar decompression procedure, or MILD.  It is a simple, safe, outpatient treatment which takes 30 minutes to perform.  Through a tiny incision, the device is placed into the spinal canal, whereby soft tissue (ligamentum flavim) and bony pedicle is removed.  This, the pressure on the spinal cord and nerve roots are immediately relieved.  This effectively and permanently alleviates the spinal stenosis within the spinal canal.  I have treated many patients with this condition, a majority of who have experienced a permanent reduction of the pain.  You can watch one of my patients discuss their benefit on my youtube channel: https://youtu.be/Jm03xsHHPTE

The opening of the space within the spinal cord restores normal functioning and mobility. The benefits of this procedure include no general anesthesia, a small incision, no laminotomy (surgical removal of body pedicle), less post operative discomfort, an outpatient procedure, and a shorter recuperative time.

The benefits and goals of the procedure are to be able to improve functioning and quality of life. Studies have shown over 50% in pain reduction, a 300% improvement in ability to walk, and a 700% improvement in ability (length of time) to stand without pain.  Overall studies show that greater than 3/4 (79%) of pts realize benefit. The complication rate is also extremely low as compared to traditional surgery which has a known complication rate as hard as 25%. Lastly, 95% of patients treated did not require any further intervention including surgery.

In conclusion, this is an effective, extremely safe and well studied treatment for neurogenic claudication due to spinal stenosis. Thousands of patients haven’t treated without any major complications.  Unlike more aggressive open surgical procedures, it is an outpatient procedure whereby patients literally walk out with less pain then they came it.  Patients have realized an improvement no only in their pain, but also their functioning, and activity level.  Many of my patients have benefited from this procedure, and without doubt it has significant advantages over traditional multilevel lumbar laminectomy surgery.  Additional information can be found at www.vertosmed.com.

Author
Dr. Todd Koppel

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