MILD procedure offers safe, minimally invasive way to treat low back pain

Graphic of a human spine

A low-risk, minimally invasive procedure offered at UF Health can help patients experiencing low back pain due to spinal stenosis, while reducing recovery time.

The short outpatient MILD® procedure to treat lumbar spinal stenosis is approved by the FDA and covered by Medicare nationwide. It requires only a small incision in the back through which small pieces of bone and excess ligament tissue are removed to relieve pressure in the spinal canal and decrease nerve compression, thus increasing mobility and reducing pain. Patients do not need sutures, staples, or general anesthesia. 

Furthermore, the procedure does not require anything to be implanted in the body. As a result, patients can typically resume normal activity within 24 hours. Because the procedure does not alter the spine’s structural stability, open surgery remains possible if needed in the future. 

Lumbar spinal stenosis involves a narrowing of the lower spine, which impairs the nerves in the spinal canal. Patients often experience neurogenic claudication, which typically involves numbness, cramping, or pain in the back, buttocks, thighs, or calves that increases with walking. Weakness or heaviness in the legs is also a symptom; patients often have to lean forward (on a shopping cart or a walker) and sit down, limiting activity. 

Because the condition is an anatomical change typically caused by wear and tear with aging, physical therapy often cannot provide sustained relief. While injections can help temporarily, MILD® is a safe treatment that is less invasive than surgery. Studies show that 79% of patients report pain reduction and increased mobility after the procedure.

“The beauty is this is a same-day procedure involving only local or light sedation,” said Rene Przkora, MD, PhD, Professor of Anesthesiology and Chief of the Pain Medicine Division. “The risks are low.”

As with all procedures, a provider must know the indications and contraindications to select candidates for this procedure as well as prioritize patient safety, said Joe Mosley, DO, a Pain Medicine Fellow who has begun training in the procedure.

“The benefits for patients are at least two-fold. One, this can decrease the amount of pain that patients are experiencing from compression on the spinal cord. Two, this procedure is minimally invasive and allows a quick recovery for the patient,” he said.

Learning MILD® at UF Health has been a unique opportunity for Dr. Mosley, who noted that the procedure, which uses fluoroscopy, takes less than 2 hours to perform.

“I had heard about minimally invasive lumbar decompression, but had never seen one as a resident,” he said. “This unique approach to help relieve patients’ pain was exhilarating and is a good tool to have in my toolbelt.”

Learn more about our Pain Medicine Division