Should a MILD procedure be performed if one had neurogenic claudication? Based on the body of evidence available, yes.
MILD is the best treatment to decompress a compromised spinal canal, especially for patients with severe spinal stenosis. The aim of mild procedure is to debulk the ligamentum flavum, allow more room in the spinal canal and alleviate patients’ pain. MILD does this with a great likelihood of preserving the integrity of the spine compared with laminectomy or fusion.
The majority of published MILD studies are positive. Available data support long-term pain relief and improvements in functionality.
After one year, 79% of patients achieved pain reduction. At the same time, the average disability scores improved by 16 points. It is clear from these findings that MILD is durable.
It was also recently reported that a series of 40 consecutive patients with neurogenic claudication were treated with MILD procedures. Pain Disability Index scores improved by 40% and the Disability scores improved by 50%. What is fascinating is the time patients were able to stand, increased from seven to 90 minutes over one year; at the same time, walking distance significantly improved from 300 to 4,500 feet.
Training and patient selection are essential. Most failed cases occur in poorly selected patients. Using imaging to confirm the clinical diagnosis is a big benefit—magnetic resonance imaging can show if a hypertrophic and thickened ligamentum flavum takes up a significant portion of the spinal canal.
MILD is a great technique to relieve pain and improve quality of life. For more information or to see if the mild procedure is right for you, contact Franklin Pain and Wellness Center.
Excerpts – Pain Medicine News