From Washington University Physicians written by Mary Jo Blackwood, RN, MPH, posted December 13, 2011
For some people, just getting around is an exercise in pain. A condition called spinal stenosis, a narrowing of the spinal canal that causes pressure on the spinal cord or its nerves, most commonly affects the lumbar, or lower back, region. Spinal stenosis can cause severe radiating pain in the back and down the legs, making standing and walking difficult.
A new procedure - called image-guided MILD - provides relief for some patients whose stenosis is due to thickening of a particular ligament called the ligamentum flavum.
The MILD® procedure (minimally invasive lumbar decompression), allows for paring down the thickened ligament, taking pressure off the nerves and relieving pain. Dr. Robert Swarm, director of the Pain Center at Barnes-Jewish Hospital and chief of the division of pain management at Washington University, says the procedure is relatively new and requires extensive training to properly administer.
“We insert instruments into the spinal canal under fluoroscopy guidance, rather than looking at the area directly through an open incision."
"In 7000 cases reviewed by the manufacturer, no significant complications were reported. Not only is that encouraging, but because we are doing the outpatient procedure under local anesthesia and i.v. sedation, we can avoid any problems patients may have with general anesthesia. Overall risks are more in line with an injection, rather than a typical surgical procedure.”
Under image guidance, a trocar (tube) is inserted into the spinal canal through which a specially