By: Dr. Adam Hammer
Millions of people suffer from debilitating low back pain as the result of cumulative degenerative changes of the “aging spine”, including degenerative disc disease, facet joint arthritis, and commonly spinal stenosis.
Typical lumbar spinal stenosis manifests as low back pain that radiates into the buttocks and occasionally the back of the thighs. Pain is typically aggravated by standing and ambulation. Patients frequently have progressively shorter walking tolerance and must stoop forward or sit down to obtain symptomatic pain relief. An imaging study such as an MRI or CT scan aids the physician in making a diagnosis.
For years, the gold standard for the definitive treatment of lumbar spinal stenosis has been open surgical decompression, involving the removal of the lamina (laminectomy) and portions of the ligamentum flavum, which directly surround the spinal nerves implicated in the pain of spinal stenosis.
Other treatments which are temporizing and can frequently provide pain relief include injections of anti-inflammatory medication into the potential space surrounding these nerves- also known as epidural steroid injections. These injections are performed with the guidance of a fluoroscope, or x-ray machine, to ensure safety and precise delivery of medication to the correct target areas in the spine. These injections can be effective in many cases for spinal stenosis, but they frequently need to be repeated at regular intervals and do not prevent disease progression.
The MILD procedure provides the best of both worlds. It is a safe, outpatient procedure with negligible recovery time that is conducted using the guidance of a fluoroscope, or x-ray machine, and it is performed through a needle the diameter of an ink-pen cartridge, similar to an office epidural steroid injection. However, what is achieved through the MILD needle-introducer is also amazingly similar to the traditional surgical treatment for spinal stenosis. A special device inserted through the MILD cannula is designed to remove portions of the lamina and ligament that are “strangling” the spinal nerves and causing stenosis pain.
Recovery from the MILD is the same day, and most patients report immediate symptomatic relief and improved walking. The MILD data thus far continues to be excellent at the two year follow-up period. Patients have sustained improved low back pain, buttock pain, improved walking tolerance, and overall improved quality of life.
If you are suffering from low back pain and lumbar spinal stenosis, and looking for a new and proven effective alternative to injections and spine surgery, ask your doctor if the MILD procedure might be appropriate for you.