May 2023

Spondylosis, Spinal Stenosis, and MILD

Minimally Invasive Lumbar Decompression, Also Known as the MILD® Procedure, is a Treatment Alternative for Stenosis of the Spine


The causes of back pain can vary widely. Diagnosing the specific causes of your back pain and deciding the appropriate alternatives to treat it is a process that you’ll discuss with your doctor.

But one of the conditions that may lead to back pain is lumbar spinal stenosis. Lumbar spinal stenosis is when your lower spinal canal narrows and compresses the spinal nerves in your lower back. This compression can lead to pain and mobility issues.

In this article, we’ll review lumbar spinal stenosis in more detail, along with a proven effective treatment in appropriate cases called the mild® Procedure.

Spondylosis / Arthritis of the Spine

Many of us will experience spondylosis in our later years. Spondylosis is another word for arthritis of the spine or degenerative disc disease. It results from normal “wear and tear” through the years on both the soft structures and bones that make up the spine. An estimated 90% of adults aged 60 years or older have this condition.

Although any part of the spine may be affected, spondylosis is more frequently seen in the cervical (neck) and lumbar (lower back) areas of the spine.

People with this degenerative condition may or may not experience symptoms. Those without any symptoms often only become aware that they have spondylosis when they are being assessed for another condition that requires imaging of the spine with an X-ray, MRI, or CT scan.

The last three decades have witnessed great leaps in diagnostic imaging quality which makes it far easier to detect the subtle signs of spondylosis clinically. The reality is that most people with spondylosis are generally asymptomatic and don’t experience significant pain or other issues related to these arthritic changes.

Challenge getting up from couch with back painHowever, when symptoms are present, they can vary significantly depending on where this condition is specifically developing. This progressive deterioration of the discs between the spine’s vertebral bodies can lead to symptoms that include pain (known as “discogenic pain”) and a limited range of motion. When this occurs in the lower back, it can indicate Lumbar Spinal Stenosis.

Lumbar Spinal Stenosis

Pausing after getting up from couch with back painMost commonly, lumbar spinal stenosis occurs when spondylosis causes the spinal canal in the lower part of your back to narrow. That narrowing can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles. It typically affects the lower L3 to L5 spinal levels of the spine, which can lead to pain that radiates into the leg.

One of the primary early symptoms of lumbar spinal stenosis is pseudoclaudication, also called neurogenic claudication. It can cause your legs to feel heavy – described by some as if they were walking in cement. Other early symptoms may include cramping or discomfort in the leg(s) after a long walk or a sensation of leg numbness or achiness after prolonged standing. In the later stages, the symptoms may progress into more severe leg pain that is exacerbated while walking.

However, lumbar spinal stenosis develops differently for everyone. Symptoms may improve, worsen, or be intermittent with occasional flareups and/or activity-related pain.

When the pain from lumbar spinal stenosis begins to affect the quality of your life, it’s time to discuss alternatives for treatment with your doctor.

Excess Ligament Tissue and MILD®

One of the major root causes of Lumbar Spinal Stenosis is the presence of excess ligament tissue that develops on the spine with spondylosis. The mild® Procedure is a minimally invasive approach to remove that excess ligament tissue to restore space in the spinal canal. This removes pressure on the spinal nerves and relieves the associated pain. MILD is an acronym for Minimally Invasive Lumbar Decompression.

The mild® Procedure typically takes less than an hour and can be performed through a single, tiny incision smaller than the size of a baby aspirin (5.1 mm). It can be performed using local anesthetic and light sedation in an outpatient surgery center. It does not significantly alter the structural anatomy of the spine but removes the excess ligament tissue which is a major root cause of pressure on the spinal canal.

This treatment option can be most commonly appropriate when other more conservative therapies – such as physical therapy, pain medications, and/or epidurals – are no longer providing adequate relief. It has a similar safety profile to an epidural steroid injection, but often with lasting results.

Mild®, however, is also only one of many other treatment options that may be appropriate for each individual patient. Your doctor will carefully consider if this is an appropriate option for you according to your safety profile and conditions.

Mild® and Main Line Spine

Mild® is one of many therapies considered and used by the Physical Medicine and Rehabilitation doctors at Main Line Spine. If live in the greater Philadelphia area and know or suspect you have Lumbar Spinal Stenosis and accompanying pain, call us to schedule an appointment to investigate the options appropriate for your situation.

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