Anyone had minimally invasive ligament decompression (MILD) treatment?

Posted by pablo81 @pablo81, Apr 13, 2023

I am considering the "MILD" treatment which debulks the ligament thereby increasing spinal canal space.

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@pablo81

Yes

I would like to find a surgeon who will do what you suggest i.e. "define all the areas that could be contributing to the spine condition".....I have used the manufacturers website and it provides pain management doctors who "do the procedure" so sorting through that becomes the issue. Are pain management doctors really qualified to do as you indicated simply because they can "do the procedure"...

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Part of my reluctance to do the MILD is conversation I have had with a ortho surgeon who stated that he does not support the procedure for me because I have severe stenosis at L2/L3 level, a pain management doc is not a surgeon and there is a major risk of permanent damage to the spinal cord at that level if too much pressure is applied. The ortho recommends laminectomy at 3 levels. I am a little confused so I am status quo.

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I have appointments with the Mayo Spine Center this October. During this visit, I'll ask the Spine Center surgeon for an opinion on whether the MILD procedure is a solution for me. I'm hesitant to contact any of the surgeons recommended by Vertos. I'm concerned that their response may be biased.

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@pablo81

Part of my reluctance to do the MILD is conversation I have had with a ortho surgeon who stated that he does not support the procedure for me because I have severe stenosis at L2/L3 level, a pain management doc is not a surgeon and there is a major risk of permanent damage to the spinal cord at that level if too much pressure is applied. The ortho recommends laminectomy at 3 levels. I am a little confused so I am status quo.

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@pablo81 I think your orthopedic surgeon gave you a good answer. I didn't realize that the MILD procedure was being done by pain management doctors instead of spine surgeons. A spine surgeon specialist has so much more expertise and training about correcting spine conditions and experience with many different procedures and spine devices and instrumentation. Specializing in Neurosurgery has training for 7 years after getting an MD.

A laminectomy is like adding a second floor on a house to make more space. Some of the bone is cut away on the "roof" of the spine to allow more space for the spinal cord inside the spinal canal. That part of the bone isn't supporting body weight like the "end plates" that surround the discs. What is it that is confusing for you about your doctor's opinion?

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@jenniferhunter

@pablo81 I think your orthopedic surgeon gave you a good answer. I didn't realize that the MILD procedure was being done by pain management doctors instead of spine surgeons. A spine surgeon specialist has so much more expertise and training about correcting spine conditions and experience with many different procedures and spine devices and instrumentation. Specializing in Neurosurgery has training for 7 years after getting an MD.

A laminectomy is like adding a second floor on a house to make more space. Some of the bone is cut away on the "roof" of the spine to allow more space for the spinal cord inside the spinal canal. That part of the bone isn't supporting body weight like the "end plates" that surround the discs. What is it that is confusing for you about your doctor's opinion?

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My reference to confusion is the different opinions I have received from different doctors. I agree with you that my ortho made a lot of sense but you hear none of that caution if you speak to the manufacturer of the device used to perform the treatment or from other docs. That is what causes the uncertainty and confusion.

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@pablo81

My reference to confusion is the different opinions I have received from different doctors. I agree with you that my ortho made a lot of sense but you hear none of that caution if you speak to the manufacturer of the device used to perform the treatment or from other docs. That is what causes the uncertainty and confusion.

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Also the ortho caution about MILD was followed by recommending a 3 level laminectomy?

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@pablo81

Yes. I could clearly hear the surgeon hammering away at the Vertiflex to get it in. It went in ok. First few days it felt like the Vertiflex was trying to push me into a stooped position which I think is normal because that is what it does i.e. simulates stooping. I now am pretty much free in terms of motion but it has not helped my "shopping cart syndrome" which got me to MILD.

I have spoken to Vertos and they take a "hands off" approach to MILD other than marketing. Defer to doctor. That seems strange since they are the experts.

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I read your response with interest. I have spinal stenosis and had a radio frequency ablation and trigger point injection at Mayo. I'm pleased Mayo offers several solutions for back pain before suggesting a surgical procedure. I'm leary of documentation offered by Vertos for vertiflex or MILD procedures.

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I guess the answer to that is no, no one has. I don’t believe Mayo even offers MILD. But I’ve seen a spine specialist who is recommending it.

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