What is Minimally Invasive Lumbar Decompression (MILD)?
The Minimally Invasive Lumbar Decompression (MILD) procedure is a safe and effective treatment option for LSS patients. It provides significant pain relief. It is a treatment of choice for those who do not tolerate general anesthesia or more invasive open spinal surgery. It is a commonly performed procedure that doctors consider to be very safe.
Advantages And Disadvantages Of The MILD Procedure
MILD is an outpatient treatment that takes less than an hour. One of the most significant advantages of MILD is that it is a minimally invasive procedure, which means it causes no major complications and results in little scar tissue formation. MILD also has the following advantages:
- There is no need for general anesthesia
- No implants or stitches
- Low risk of complications
- Significant pain relief
- Able to restart light activities in a couple of days
While there are lots of benefits, there is a possibility that the procedure may not alleviate pain and may potentially worsen it. Infection or bruising around the site is possible, but it should go away in a few days. However, these concerns are negligible because infections can be treated with antibiotics.
Why is Minimally Invasive Lumbar Decompression (MILD) Performed?
When the gaps between the vertebral bodies, or spinal bones, narrow, this is known as spinal stenosis. This narrowing compresses the spinal canal, pinching the spinal cord and nerve roots. It can cause pain, weakness, or numbness, especially in the legs and feet.
The vertebrae are the 33 bones that make up the spinal canal. The spinal cord, which runs from the base of the skull down through the lower back, is present in the spinal canal. The spinal cord divides into a bundle of nerve roots at its base. These nerve roots arise from the spinal canal via gaps in the vertebrae.
Lumbar spinal stenosis means “the narrowing of the spinal canal in the lower back.” Stenosis, which means narrowing, can put pressure on your spinal cord or the nerves that connect to your muscles. Spinal stenosis can occur anywhere in the spine, but it is most common in the lower back. This area of your spine is known as the lumbar region. It consists of the lower five lumbar vertebrae.
Symptoms
There may be no symptoms of early lumbar spinal stenosis. Symptoms appear gradually in the majority of people. Symptoms may include:
- Pain or discomfort in the lower back
- Burning sensation in the buttocks and down the legs (sciatica)
- Leg numbness, tingling, cramping, or weakness
- Sensation loss in the feet
- A foot weakness that induces the foot to slap down when walking (foot drop)
- Loss of Sexual ability
Causes
The most prevalent cause of lumbar spinal stenosis is osteoarthritis. It is the progressive wear and tear of your joints over time. Spinal stenosis is common because osteoarthritis causes changes in the spine by age 50 in many people. As a result, the majority of people who develop symptoms of lumbar spinal stenosis are over the age of 50. Women are more likely than men to develop lumbar spinal stenosis.
In addition to osteoarthritis, several other conditions can cause lumbar spinal stenosis. These include:
- Spinal cord injury
- Tumor of the spine
- Several bone diseases
- History of Spine surgery
- Rheumatoid arthritis
How is Minimally Invasive Lumbar Decompression (MILD) Performed?
If the doctor diagnoses someone with LSS, then MILD is a quick outpatient procedure that requires no general anesthesia or stitches and is performed through a small incision. MILD is an FDA-approved procedure.
The first step in this procedure is to clean the lower back area with an antiseptic solution. Then to numb this area, the doctor will use local anesthesia. The doctor will make a small incision while the patient is lying face down on the operating table.
The doctor will insert multiple tubes through the incision to allow access to the spine by opening up the space around the muscles. A final tube (the size of a dime or nickel) is inserted to allow the insertion of specialized tools. These are used to remove small pieces of bone and excess ligament that cause the canal to narrow.When the procedure is finished, the tools and tube are removed, and the incision is closed and bandaged.
Some doctors have compared treating LSS to “removing a kink in a drinking straw.” An imaging machine is used to assist your doctor during the procedure. The restoration of space in the spinal canal reduces nerve compression. It relieves pain and improves mobility.
What To Expect After Minimally Invasive Lumbar Decompression (MILD)
When you are ready to go home, you will most likely require pain medicines or a muscle relaxer if you have any post-operative pain or muscle spasms during the recovery phase. Your bandage will be removed within a few days to a week of the treatment. Around this time, you should be able to resume regular activities and return to work. However, it is necessary to rest and limit activity to light movements for a few days after the procedure.
