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The MILD procedure
Gabor B Racz1, James E Heavner, Hemmo Bosscher
1Anesthesiology and Pain Management, Texas Tech University Health Sciences Center, Lubbock, Texas 79430, USA.
Summary
Minimally invasive lumbar decompression (MILD) shows favorable long-term results for spinal stenosis. However, potential major complications and questions about efficacy necessitate further clinical guidance.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Minimally Invasive Procedures
Background:
- Spinal stenosis due to hypertrophied ligamentum flavum (LF) is a common condition.
- Minimally invasive lumbar decompression (MILD) has emerged as a treatment option.
- There are ongoing discussions regarding the long-term efficacy and safety of the MILD procedure.
Purpose of the Study:
- To evaluate the generally favorable long-term results of the MILD procedure.
- To consider cautionary surgical observations and opinions on MILD.
- To address the need for a clinical algorithm for MILD use.
Main Methods:
- Review of existing literature and clinical observations.
- Analysis of reported long-term outcomes for MILD.
- Consideration of reported complications and efficacy data.
Main Results:
- Favorable long-term impressions of the MILD procedure exist.
- Some reports highlight potential major complications associated with MILD.
- Concerns regarding efficacy and placebo effect have been raised.
Conclusions:
- The MILD procedure is perceived as virtually safe by some.
- Major complications have been described by certain surgical opinions.
- A clinical algorithm is needed to guide the use of MILD for spinal stenosis.
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