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Patient Question

What is Minimally Invasive Lumbar Decompression or MILD?



Assistant Professor
Director, Center for Chronic Pain Management at Stony Brook
Expert Answer

Lumbar spinal stenosis (LSS) affects more than 1.2 million people each year in the U.S. Minimally Invasive Lumbar Decompression (MILD) is performed to treat LSS.

What are the treatment options for LSS?
Traditionally, an open operation by a spine surgeon may be done to alleviate the pressure on the nerves in your lower back. This requires a general anesthetic and a few days in the hospital, as well as an extended period of recovery. However, there is a new alternative available to some patients with LSS that can be done as an outpatient under local anesthesia with sedation provided by an anesthesiologist.

The MILD procedure or Minimally Invasive Lumbar Decompression procedure, uses ultra-minimally invasive tools to gain access to the area of the lumbar spine that is causing the stenosis. The MILD procedure has been performed in the U.S. on over 6000 patients since 2008 and has been performed at Stony Brook University Medical Center by Dr. Brian Durkin since 2010. Most procedures are done at the Ambulatory Surgery Center, take between 1 and 2 hours to perform, and patients are discharged home usually an hour after the procedure is done.

What exactly is LSS and how can you tell if you are suffering from it?
If you do suffer from LSS, you'll likely notice a numbness in your legs or a "pins and needles" sensation when you're active. You may have to hold on to something to catch your balance just to bend over. Walking or standing can make the pain even worse. Grocery shopping or just getting the mail can become a painful chore that requires resting or sitting in order to relieve the leg pain. Sitting down, putting your feet up, or bending forward while walking are other ways to stop the pain caused by LSS.

Your spine provides support for your back and body. It also protects the spinal cord, the bundle of nerve tissues that runs from your brain to your lower body. The bony channel that encloses the spinal cord is called the spinal canal. Usually, there is enough space between the spinal cord and the spinal canal so that the nerves that flow through and exit the spinal canal are free of obstruction.

As your body ages, however, the ligaments and bones outside the spinal canal may thicken and begin to press on the spinal canal, causing it to narrow. This narrowing of the spinal canal is called spinal stenosis. When that occurs in the lower part of the spine, it's called lumbar spinal stenosis. This narrowing of the canal can compress or pinch nerve tissues, resulting in pain, numbness and disability.

If you would like to learn more about the MILD procedure, call (631) 638-PAIN for a consultation with Dr. Durkin at the Center for Pain Management at Stony Brook University Medical Center.

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