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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.

Pain Practice : the Official Journal of World Institute of Pain
|March 23, 2013
PubMed

Insights

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.
Keywords:
MILD procedurecomplicationsoutcomessafety

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