Minimally Invasive Lumbar Decompression (MILD)

We have helped many of our patients with spinal stenosis improve significant results with the MILD procedure.  Schedule a consultation to see if you would be a good candidate

What is the MILD procedure?

The Minimally Invasive Lumbar Decompression (MILD) procedure offers targeted relief for patients suffering from lumbar spinal stenosis, a painful condition caused by the narrowing of the spinal canal, which compresses the nerves. This technique is performed under local anesthesia with light sedation, requiring only a small incision in the lower back. During the procedure, specialized instruments are used to meticulously remove small portions of bone and the thickened ligamentum flavum, responsible for the narrowing and nerve compression. The MILD procedure is distinctively less invasive than traditional surgery, promoting a quicker recovery and allowing patients to return to their daily activities shortly after the surgery. As an outpatient procedure, it minimizes hospital stay and has been shown to effectively reduce pain and improve mobility in patients, making it a valuable option for those who have not seen improvement with conservative treatment methods.

The MILD procedure is related to but distinct from a traditional laminectomy, both aiming to relieve symptoms of spinal stenosis. A laminectomy is a type of surgery that involves removing a portion of the vertebral bone called the lamina to relieve pressure on the spinal nerves or cord. It's a more invasive procedure that often requires general anesthesia and a longer recovery period.

We employ the specialized tools provided by Vertos Medical for the MILD procedure and are trained in the latest advancements in this minimally invasive technique.

What are the benefits and risks of the MILD procedure?

The MILD (Minimally Invasive Lumbar Decompression) procedure, designed to alleviate symptoms of lumbar spinal stenosis, offers several benefits and carries certain risks, as with any medical procedure. Understanding these can help you make an informed decision about treatment.

Here’s a short summary of potential advantages and disadvantages:


  • Minimally Invasive: A small incision and minimal tissue disruption lead to less postoperative pain and a lower risk of complications compared to traditional open surgery.
  • Local Anesthesia: The use of local anesthesia with light sedation, rather than general anesthesia, reduces risks associated with the latter and can make the procedure available to patients with higher surgical risks.
  • Quick Recovery: Patients typically experience a faster recovery time, often returning to normal activities within a short period post-procedure.
  • Effective Pain Relief: Many patients report significant relief from symptoms of lumbar spinal stenosis, including reduced pain and improved mobility.
  • Outpatient Procedure: The MILD procedure can be performed on an outpatient basis, eliminating the need for a hospital stay and potentially reducing healthcare costs.


  • Infection: Although the risk is minimized due to the procedure's minimally invasive nature, any surgical intervention carries a risk of infection.
  • Bleeding: There is a potential for bleeding, though it is typically less severe than with more invasive surgeries.
  • Nerve Damage: There is a small risk of nerve damage, which could result in numbness, weakness, or pain.
  • Nerve Damage: While rare, there is a risk of nerve damage during the procedure, which could result in numbness, weakness, or pain.
  • No Improvement or Recurrence: Some patients may not experience significant improvement in their symptoms, and in some cases, symptoms may recur over time.
  • Need for Additional Surgery: In cases where the MILD procedure does not provide the desired relief, or if symptoms worsen, additional surgery may be necessary.

The MILD procedure offers a less invasive option for patients with lumbar spinal stenosis, leading to quicker recovery and reduced pain.  However, we recommend that you schedule a consultation with us to thoroughly understand the potential benefits and risks based on your specific health condition and needs.

Who is a good candidate for the MILD procedure?

Good candidates for the MILD (Minimally Invasive Lumbar Decompression) procedure are individuals suffering from lumbar spinal stenosis (LSS), a condition characterized by the narrowing of the spinal canal which causes pressure on the spinal cord or nerve roots, leading to pain, numbness, or weakness in the legs and lower back. Ideal candidates typically meet the following criteria:

  • Symptomatic Lumbar Spinal Stenosis: Diagnosis of lumbar spinal stenosis with symptoms that significantly impact quality of life, including leg or back pain, numbness, weakness, and difficulty walking.
  • Failed Conservative Treatments: Have tried and not responded adequately to conservative treatments such as physical therapy, medications, and epidural steroid injections for a reasonable period.
  • Absence of Severe Spinal Instability: Candidates should not have significant spinal instability, such as spondylolisthesis, that would require a more invasive surgical intervention for stabilization.
  • No Significant Deformity: The procedure is most suited to patients without major spinal deformities that would otherwise necessitate corrective surgery.
  • Overall Good Health: While the MILD procedure is less invasive and performed under local anesthesia, candidates should be in generally good health to tolerate the procedure and the sedation used.
  • Realistic Expectations: Understanding the goals of the procedure, potential outcomes, and the importance of post-procedure care and follow-up.

The MILD procedure is particularly beneficial for older adults or those with comorbidities that make them less suitable candidates for more invasive surgeries. However, the determination of who is a good candidate for the MILD procedure should be made after a thorough evaluation.  During your pain management consultation, we will evaluate your specific symptoms, overall health, and spinal imaging results to determine if this procedure is right for you.

How is the MILD procedure performed?

Here is a general overview of how the MILD procedure is performed:

  • Preparation: The patient is given local anesthesia along with light sedation to ensure comfort throughout the procedure, minimizing pain and anxiety.
  • Incision: A small incision, typically less than an inch long, is made in the skin over the affected spine area. This minimally invasive approach reduces tissue damage and the risk of complications.
  • Access: The surgeon makes a small incision (typically less than one inch) in the back at the targeted level of the spine. This minimally invasive approach helps reduce the risk of infection and shortens recovery time.
  • Visualization: Using fluoroscopy, a type of real-time X-ray imaging, the surgeon guides instruments to the precise location within the spinal canal that requires decompression. This imaging technique allows for accurate targeting while minimizing damage to surrounding tissues.
  • Decompression: Specialized tools are used to remove small portions of bone and excess ligamentum flavum, the thickened ligament that contributes to the narrowing of the spinal canal. By carefully removing these structures, the procedure aims to relieve the pressure on the nerves.
  • Closure: Once the decompression is complete, the incision is closed with sutures or staples, and a sterile dressing is applied. The small size of the incision contributes to a quicker, less painful recovery period.
  • Recovery: The MILD procedure is generally performed on an outpatient basis, meaning patients can go home the same day. Postoperative instructions typically include rest, gradual return to activities, and possibly physical therapy to strengthen the back and improve flexibility.

The MILD procedure's minimally invasive nature, requiring only local anesthesia and light sedation, significantly reduces the risks associated with more invasive spinal surgeries and promotes a faster return to normal activities. It's a targeted approach designed to provide relief from the pain and mobility issues associated with lumbar spinal stenosis.

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