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Mild® procedure

In Phoenix Arizona

Atlas Pain Specialists offers the mild® Procedure in Phoenix, AZ as a minimally invasive option for lumbar spinal stenosis. This treatment helps relieve pressure on nerves by reducing ligament thickening, allowing for improved mobility and reduced discomfort. Our experienced team works closely with you to determine if the mild® procedure is the right choice for your pain management plan.
Overview

What is the mild® procedure?

The Minimally Invasive Lumbar Decompression (Mild®) procedure is an innovative, outpatient treatment designed for patients suffering from lumbar spinal stenosis (LSS). This condition occurs when the spinal canal narrows, putting pressure on the nerves in the lower back, causing pain, numbness, and mobility issues. The Mild® procedure helps by removing small pieces of bone and thickened ligaments that are compressing the spinal nerves, restoring space without the need for major surgery or implants.

Mild® is an FDA-cleared, low-risk alternative to traditional open surgery, offering significant symptom relief while preserving the spine’s stability. Because the procedure is done through a small incision with no general anesthesia or stitches required, recovery is quick and patients often return to normal activities within days. Many individuals experience improved mobility, reduced pain, and a better quality of life, making Mild® an excellent option for those looking to avoid more invasive spinal surgeries.

Benefits of the 
Mild® Procedure

Minimally Invasive with No General Anesthesia

The Mild® procedure is designed to be as minimally disruptive as possible, reducing the risks associated with traditional spinal surgeries. Unlike open back surgery, which often requires general anesthesia and significant tissue disruption, Mild® is performed through a small incision, eliminating the need for stitches and extensive recovery. Patients remain awake and comfortable under local anesthesia, allowing them to avoid the complications of general anesthesia, such as nausea, dizziness, or respiratory issues. Because of its minimally invasive nature, this approach significantly reduces surgical risks and allows for a faster return to daily activities.

Preserves Spinal Stability

Traditional decompression surgeries, such as laminectomy, often involve removing large portions of bone or inserting implants, which can alter the spine’s natural mechanics and potentially lead to instability. Mild® avoids these issues by carefully removing only small pieces of ligament that are compressing the spinal nerves, ensuring that the structural integrity of the spine remains intact. This means patients retain normal mobility, strength, and flexibility after the procedure, avoiding the risks of spinal instability, which can sometimes result in the need for additional surgeries, such as spinal fusion. Mild® preserves your spine’s natural function while relieving pain.

Quick Recovery & Outpatient Procedure

One of the biggest advantages of the Mild® procedure is its fast recovery time compared to traditional spinal surgeries. Since the procedure is performed through a tiny incision with minimal tissue disruption, patients go home the same day and can return to light activities within 24 to 48 hours. There is no need for extended hospitalization, lengthy rehabilitation programs, or long periods of downtime. Many patients experience noticeable improvements in mobility and comfort within weeks, allowing them to resume work, exercise, and daily routines much sooner than those undergoing more invasive procedures.

Significant Pain & Symptom Relief

Patients suffering from lumbar spinal stenosis (LSS) often experience debilitating leg pain, numbness, and difficulty walking, limiting their ability to perform daily activities. The Mild® procedure effectively restores space in the spinal canal, relieving pressure on the nerves and reducing pain, weakness, and mobility issues. Many patients experience a dramatic improvement in their ability to walk longer distances without pain or needing to stop and rest. By addressing the root cause of nerve compression, Mild® offers long-lasting symptom relief, allowing patients to regain independence and a better quality of life without the need for major surgery.

Reduced Need for Pain Medications

Chronic spinal stenosis pain often leads patients to depend on opioids and other pain medications for relief, which can result in tolerance, dependency, and unwanted side effects such as drowsiness, nausea, and cognitive impairment. Mild® directly treats the cause of nerve compression, significantly reducing the need for long-term pain medication use. Many patients find that after undergoing the procedure, they can decrease or eliminate their reliance on opioids and NSAIDs, reducing the risk of medication-related complications. By offering a drug-free, long-term solution, Mild® allows patients to manage their pain safely and effectively without the need for daily medication

Alternative to Open Surgery

For patients who are not candidates for spinal fusion, laminectomy, or other invasive back surgeries, the Mild® procedure provides a safer, highly effective alternative. Many individuals, especially older adults or those with pre-existing health conditions, may not be able to undergo traditional back surgery due to the risks associated with anesthesia, long recovery periods, or spinal instability. Mild® is an outpatient procedure with a lower risk profile, making it a viable option for patients seeking meaningful pain relief without the complications of major surgery. Clinical studies have shown that Mild® delivers long-term success, allowing patients to remain active and pain-free.

Conditions Treated with the Mild® Procedure

Mild® is primarily used to treat lumbar spinal stenosis (LSS), a condition that causes narrowing of the spinal canal, leading to nerve compression. This procedure may also be considered for patients experiencing
Neurogenic Claudication  – Pain, weakness, or numbness in the legs caused by compressed spinal nerves.
Thickened Ligamentum Flavum – Overgrown spinal ligaments that contribute to nerve compression and reduced mobility.
Difficulty Walking or Standing  – Patients who experience pain relief when sitting or bending forward may benefit from decompression through the Mild® procedure.
Chronic Lower Back Pain – Mild® can be a non-surgical alternative for some patients with degenerative spinal conditions causing stenosis-related pain..

Purpose

Limitations

Risks

Process

Types

Purpose of the Mild® Procedure

The goal of the Mild® procedure is to relieve nerve compression in the lumbar spine caused by excess ligament growth and bone overgrowth. By carefully removing these obstructing tissues, the procedure creates more space for the spinal canal, reducing pressure on the nerves and alleviating pain, numbness, and difficulty walking.

Unlike traditional spinal surgeries, which may involve extensive tissue removal or fusion, Mild® focuses on minimally invasive decompression, making it a safer option for older adults or those with medical conditions that make major surgery risky. By restoring mobility and reducing pain, Mild® allows patients to return to daily activities without the need for long-term pain management or extensive rehabilitation.

Limitations of the Mild® Procedure

While the Mild® procedure is effective for many patients, it is not suitable for all cases of spinal stenosis. Patients with severe spinal instability, large herniated discs, or significant structural deformities may require more extensive surgery.

Additionally, Mild® primarily targets ligament overgrowth, so if bone spurs, disc degeneration, or spondylolisthesis are the main sources of stenosis, the procedure may not provide complete relief. It is also not a cure for spinal stenosis, but rather a way to manage symptoms and improve function without major surgery. A thorough evaluation, including imaging tests, is necessary to determine if Mild® is the right treatment option.

Potential Risks of the Mild® Procedure

Although Mild® is a low-risk, minimally invasive procedure, like any medical intervention, it carries some potential complications. These risks are rare but may include:

  • Temporary Pain or Discomfort – Some patients may experience soreness at the incision site or temporary back pain following the procedure.
  • Infection – Although uncommon, there is a small risk of infection at the incision site.
  • Bleeding or Bruising – Minimal bleeding is expected, but excessive bruising may occur in rare cases.
  • Incomplete Symptom Relief – While many patients experience significant improvement, some may still require additional treatment for complete relief.
  • Allergic Reaction – Some individuals may have a reaction to local anesthesia or contrast dye used during the procedure.

Overall, the risk of complications is significantly lower compared to open spine surgery, making Mild® a safer option for many patients.

The Mild® Procedure Process

The Mild® procedure is performed in an outpatient setting under local anesthesia. The steps include:

  1. Patient Preparation – The patient is positioned face-down, and local anesthesia is applied to numb the lower back.
  2. Fluoroscopic Guidance – Using real-time X-ray imaging, the physician precisely locates the thickened ligament causing the spinal compression.
  3. Micro-Incision & Tissue Removal – A tiny incision (about 5mm) is made, and specialized surgical instruments are used to remove excess ligament tissue, restoring space in the spinal canal.
  4. Verification & Closure – Once decompression is complete, fluoroscopic imaging confirms increased space for the nerves. No stitches are required—just a small bandage.
  5. Recovery & Follow-Up – Patients are monitored briefly before being discharged the same day. Most can resume light activity within 24–48 hours and feel progressive pain relief over the following weeks.
Types of Vertebral Compression Fractures Treated with Kyphoplasty

Kyphoplasty is most effective for acute or subacute compression fractures, meaning fractures that are relatively recent and still causing pain. Some of the common types include:

  • Wedge fractures: The front of the vertebra collapses, creating a wedge-like shape and leading to kyphosis (hunchback posture).
  • Biconcave fractures: The middle of the vertebra collapses, causing the bone to become concave in appearance.
  • Crush fractures: The entire vertebra collapses uniformly, which can lead to severe instability.

The type and severity of the fracture determine whether kyphoplasty or another treatment approach is best.

Types of Minimally Invasive Spinal Decompression Procedures

While Mild® is a specific technique, other minimally invasive spinal decompression procedures exist for treating lumbar spinal stenosis and related conditions:

  • Mild® Procedure – Targets ligament overgrowth to decompress the spinal canal.
  • Percutaneous Discectomy – Used to remove herniated disc material pressing on spinal nerves.
  • Endoscopic Decompression – A small camera and tools are used to remove bone spurs or thickened tissue causing nerve compression.
  • Interspinous Spacer Implantation – A small device is implanted between vertebrae to maintain spinal space and relieve nerve pressure.

Each procedure is tailored to the patient’s specific spinal condition, with Mild® offering a safe, effective alternative for those with ligament-related spinal stenosis.

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