MILD Procedure for Lumbar Spinal Stenosis
The MILD procedure (Minimally Invasive Lumbar Decompression) is an innovative, outpatient treatment for lumbar spinal stenosis causing neurogenic claudication — the leg pain, numbness, and weakness that occurs with walking and is relieved by sitting or bending forward.
What Is Neurogenic Claudication?
Neurogenic claudication occurs when thickened ligamentum flavum (the ligament lining the spinal canal) narrows the space available for the spinal cord and nerves. Patients typically describe pain, heaviness, or cramping in the legs with walking that requires them to stop and rest or sit down to get relief.
How MILD Works
Using a small incision (about the size of a baby aspirin — no stitches required), Dr. Rubin uses specialized tools to remove small portions of the thickened ligamentum flavum and small bits of bone, restoring space in the spinal canal without fusion, implants, or general anesthesia. The procedure is performed under local anesthesia with light sedation as an outpatient.
Who Is a Candidate?
Ideal candidates have:
- Lumbar spinal stenosis with neurogenic claudication confirmed on MRI
- Back pain relief when bending forward or sitting
- Failed conservative treatment (physical therapy, injections)
- A body mass index appropriate for the procedure
Results
Clinical trials show that MILD significantly improves walking tolerance, reduces pain, and improves quality of life. In the ENCORE randomized controlled trial, patients treated with MILD achieved durable improvements maintained at 2-year follow-up — with outcomes superior to continued epidural steroid injections alone.
Advantages
- No general anesthesia — performed under local with light sedation
- No fusion, rods, or implants
- Outpatient procedure — go home the same day
- No stitches — incision closes on its own
- Covered by Medicare and most commercial insurance
Learn More
Call 516-492-3100 to discuss whether the MILD procedure is an appropriate option for your lumbar spinal stenosis.