Connect
Any realistic alternatives to surgery for severe lumbar stenosis?
63 year old male with various older guy health issues but otherwise fit and active (weights, softball, tennis, walking). Had some left buttock pain in summer '24 at the very beginning of activity but went away. Fall 2025 it came back more regularly and it became more painful and disabling and sometimes including sensations down the left leg.
Finally diagnosed via MRI as severe stenosis at L4/L5 with some disc slippage or whatever to boot. Orthopedist said I likely need surgery and sent me to spine surgeon. Surgeon said I likely did, but could first try an epidural injection and perhaps some PT. Epidural injection provided a moderate amount of relief for about 3 weeks, then back to living on advil. Surgeon said laminectomy with spinal fusion is next step whenever I'm ready for it. (Haven't tried PT since both surgeon and epidural doc said it wasn't going to truly fix anything and I've always hated PT anyway, but did schedule an appointment for that too.)
Like most people, I don't want spine surgery, particularly any that includes "spinal fusion". Do I have any real alternatives here?
I'm read about somethigng called MILD and other versions of minimally invasive procedures but don't know if they are legit or not, and if they are, if my particular condition could be fixed that way. I've scheduled both a second opinion with a regular surgeon and at two other places that supposedly offer the MILD type procedures.
Anyone with any experience with any of the above, please share your thoughts. Thanks.
Like
Helpful
HugInterested in more discussions like this? Go to the Spine Health Support Group.
Connect
Yes, MILD is legit. I would do that first before any surgery. You should have it done by someone who specializes in that procedure. I had it done by a pain intervention specialist with the extra training to perform it. Meant to address stenosis, the procedure itself was a piece of cake.
-
Like -
Helpful -
Hug
1 ReactionThis is the first I have heard of the MILD procedure and I wish I had known about it earlier. Actually I wish I had been diagnosed earlier. I have had nerve pain in my left leg for more than 10 years but it's my own fault for not speaking up about it for way too long. I now have DDD, 2 herniated discs, spinal stenosis and severe bilateral foraminal stenosis at L3-S1 along with spondylolisthesis at L4 and L5. The pain is now in both legs and the right side of my back. I was treated with PT, epidurals and nerve ablations for a few years and they did help but they are beginning to become less effective. I just scheduled a laminectomy and TLIF and I am terrified. You might get temporary relief with the conservative procedures but don't wait too long. Good luck with your decision, I hope you qualify for the MILD procedure.
@llander1966
I had what I believe is this exact procedure end of October 2025. Didn't help at all; and now the persistent aching pain front of my upper left leg and down to the ankle is persistent; even at night, turning over in bed is painful. it doesn't subside during the day for about 4 hours after I rise; and often requires me to walk, sit and continue walking for a mile before it eases. I can't even stand up straight in the mornings without 7 or 8 level pain around left side of spine, across my hip and under the kidney...Afternoons and evenings are better.
this was my third surgery in 25 years; laminectomy and 2-level fusion eliminated the pain. this one failed. I agreed to do this minimally invasive procedure in lieu of expanding my 2-level fusion to a 3-level; which I bet would have cured this situation.
I'm 76.
-
Like -
Helpful -
Hug
1 ReactionI have severe L4/5 spinal stenosis and was experiencing crippling sciatica pains. I did training and began following the Gokhale Primal Posture method. I’ve been virtually pain free for several years now.
@sbcarcht
What is the Gokhale Primal Posture method? would love to hear more details..
-
Like -
Helpful -
Hug
1 Reaction@jackiet What is the MILD procedure?
Minimally Invasive Lumbar Decompression.
Basically a cleanout around central nerves and bone renoval on lamina and such to make more room for nerves.
I had a 3 level and it was partially sucessful.
Doesn't help much for severe foraminal stenosis.
My understanding is that MILD only works if the stenosis is caused by Ligament issues. I asked my pain guy about it & he said it wouldn't help me because my stenosis is scoliosis based. I've found almost nothing that helps (But no surgery), although acupuncture did help a lot for about a year. Seems to not be doing the job anymore. But I did have to change acupuncturists, and that could be the contributing factor. THe person who first got me relief said it is so dependent on the provider. Unfortunately, the one who helped me lives in Japan now.
-
Like -
Helpful -
Hug
1 ReactionHad the MILD procedure done a year ago and no more leg and buttock pain. Now I still have back issues but the crippling pain down my leg is gone from day one. Procedure was easy and no side effects. I had tried injections for a year, PT off and on for a couple of years both would help a little but since the MILD procedure pain free in that area.
At UCSF, epidurals with 3D guided CT scan. They can get around the bone spurs and whatever else in my spine for a more direct “hit” on the compressed nerve in L5-L4/S1. Worked well for me. Lasted 3 1/2 months. Doing another one soon. If i ever do surgery it would be the decompression. I’m very active and will continue all the core work, weight lifting, etc., to strengthen the muscles around my spine. Love being active, hate the idea of downtime if i do the decompression so the CT 3D guided works for me for now. I’m 73. Lower leg pain symptoms, moderate/sever stenosis.