MILD (minimally invasive ligament decompression) and/or LinQ?

Posted by ladeedi51 @ladeedi51, Apr 21, 2023

hi everyone, I am a 72 year old female who has had low back pain for the last 20+ years. I have severe spinal stenosis in the L4 – L5 region. I have tried every injection out there to no relief I correct that I did have pain going down my left outer leg and the injections seem to help that no more pain, I’m very grateful for that.
A year ago I had the Vertiflex device inserted between L4-L5 - my recovery for supposedly a non-invasive surgery was awful and the worse part it didn’t help at all.
Went through all that for nothing.
My doctor now wants to do the MILD (Minimally invasive ligament decompression) procedure. This is where they remove some of the thickening ligaments around your disc, it creates more space between the disc supposedly reducing the pain. No large incision, no stitches just a band aid. I’m hesitant to do it because of my experience with the Vertiflex.
I was wondering has anyone had this MILD procedure-how was recovery, was it successful?
Also, doctor mentioned having the LinQ
Another minimal invasive surgery.
I would love to hear from anyone who had this procedure done and how you are doing today.
I appreciate any information you may offer.

Interested in more discussions like this? Go to the Spine Health Support Group.

So do you or don’t you recommend the MILD procedure as opposed to invasive surgery !

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@pablo81

MILD is one of many minimal procedures. It does seem to make sense provided there is a clear rationale and the doctor can explain and show it to you on imaging. I recall that VERTOS the medical equipment company that developed the technology does not recommend MILD for "severe" stenosis.

I am still interested but cannot get anyone to show me and explain it adequately. For time being I am resorting back to exercise and weight loss and so far so good.

I have also had Verti flex for shopping cart syndrome to no effect.

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If the procedure is not very invasive, I figure it’s worth a shot, as opposed to invasive. My doctor gave me a pamphlet and said I wasn’t ready for it yet , but down the line for spinal stenosis. It is being used as a first line treatment. Insurance started covering it as well
Just trying to see who had it since it newer. I still need epidural injections in other areas as well.

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I had it done May 30th. I have to say it helped somewhat. Got rid of the calf pain in my legs. Every now & then after sitting to long I get some right back pain & upper leg but gets better if I move around more. So I think it was worth having it done.

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I am a 72 year old woman and also have severe stenosis and severe lower back and groin pain that has stopped me in my tracks for over two years. I have had osteopenia since my late 30’s along with spinal degeneration, arthritis and spondylolysthesis. I had two orthopedic surgeons push traditional spinal surgery that included a rod, blades, screws and pins. I felt my bones couldn’t handle that and resisted. I tried physical therapy, otc pain meds and a chiropractor which I regret. Nothing helped. I went from being very active to barely being able to stand let alone walk. I was a very unhappy couch potato. I visited a pain management clinic that offered some homeopathic alternative treatments and brought my MRI disc with me. The Dr. reviewed it and felt I was a candidate for the MILD (mildly invasive lumbar decompression) procedure. He said he saw many patients with my exact MRI, who did not have my type of nerve pain. He said that my ligament flavum was thickened and that he felt that reducing it through the M.I.LD. procedure would relieve the pressure on my nerves. After seeing the Dr. who performs this procedure and after a committee approved me for it I had it done last Monday. I was told it could take 3 to 6 months to feel improvement but 5 days later I’m feeling much better. I’m standing straighter and the pain has decreased. I’m feeling very optimistic and urge anyone with back pain to look into this procedure to see if it could work for them. I am so grateful that I didn’t rush into traditional spinal surgery. I was awake and mildly sedated during the procedure, and felt no pain. I walked back to the room and went home the same day. There is plenty of information regarding this procedure online and it has a high success rate. I wish you the best of luck.

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I had vertiflex procedure and it didn't help. Now one of the Spacers has become dislodged and my pain is worse. Has anyone had one removed??

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@billweigle

I had the MILD procedure about six months ago for my intolerable lower back hip, and thigh pain and weakness and the procedure was not at all helpful. I still struggle with the same problems which make walking and standing extremely painful. Bill Weigle

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I had MILD last October and the doctor said he knew it would work. My PCP warned me that MILD is a cash cow for practitioners and the research was funded by Vertos. I went ahead anyway because, as all sufferers of back issues know, I wanted to believe there was a safe fix. It did not work. I had my procedure done at Univ. of Penn. After, this totally unsuccessful procedure I was unable to contact the doctor until I jumped through many hoops. Prior to the procedure he said he would be with me for the long haul. I would really like to find a knowledgeable doctor who would provide honest answers to my questions and who doesn't have a financial incentive. I'm looking for evidence based solutions or in lieu of that just the facts.

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@pablo81

I am right where you are. I had Vertiflex installed at l2/l3 for severe stenosis with "shopping cart syndrome". Did not help "shopping cart syndrome" at all. Now I am looking in to MILD. My concern is the procedure could worsen my severe stenosis because I have very little space (5.2 mm) for spinal nerves to pass. Seeking folks who may have had the procedure with similar conditions than me that was successful.

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Please read my prior comment before you proceed. and good luck!

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@kdks99

I had MILD last October and the doctor said he knew it would work. My PCP warned me that MILD is a cash cow for practitioners and the research was funded by Vertos. I went ahead anyway because, as all sufferers of back issues know, I wanted to believe there was a safe fix. It did not work. I had my procedure done at Univ. of Penn. After, this totally unsuccessful procedure I was unable to contact the doctor until I jumped through many hoops. Prior to the procedure he said he would be with me for the long haul. I would really like to find a knowledgeable doctor who would provide honest answers to my questions and who doesn't have a financial incentive. I'm looking for evidence based solutions or in lieu of that just the facts.

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Criteria for MILD is 1. Greater than >2.5 mm ligamentous thickness, 2. anterothesis < 5 mm with absence of spinal instability. No one has yet been able to demonstrate this to me therefore have not proceeded but still open to it. Looking.

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@kdks99

I had MILD last October and the doctor said he knew it would work. My PCP warned me that MILD is a cash cow for practitioners and the research was funded by Vertos. I went ahead anyway because, as all sufferers of back issues know, I wanted to believe there was a safe fix. It did not work. I had my procedure done at Univ. of Penn. After, this totally unsuccessful procedure I was unable to contact the doctor until I jumped through many hoops. Prior to the procedure he said he would be with me for the long haul. I would really like to find a knowledgeable doctor who would provide honest answers to my questions and who doesn't have a financial incentive. I'm looking for evidence based solutions or in lieu of that just the facts.

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@kdks99 I can appreciate your comment about financial incentives influencing provider's recommendations for procedures. I can tell you as a patient from my experience at Mayo, there is not a financial bias for the surgeon to perform surgery. Mayo staff are all employees of Mayo and are paid the same salary if they do or don't do surgery. I think that gives a more objective and honest opinion. My surgeries at Mayo have been a cervical spinal fusion and fixing a broken ankle. I also found my physical therapist to be very knowledgeable about surgeries because she rehabs people before and after them and had knowledge of doctors and surgical procedures by treating their patients. Another source of evidence based information is medical literature and that can be found online. Sometimes, all you can see is the abstract, and other times, you can find a complete paper available without having to pay to read it. On the Mayo website, publications are listed in the physician profiles and you can look at those online. You can always search for a surgeon online and may find research papers if they are publishing. I think surgeons at major medical centers are the ones leading new innovations their field and publishing rather than surgeons in private practices. Medical journals have peer review by experts in the field before a paper is published.

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@jenniferhunter

@kdks99 I can appreciate your comment about financial incentives influencing provider's recommendations for procedures. I can tell you as a patient from my experience at Mayo, there is not a financial bias for the surgeon to perform surgery. Mayo staff are all employees of Mayo and are paid the same salary if they do or don't do surgery. I think that gives a more objective and honest opinion. My surgeries at Mayo have been a cervical spinal fusion and fixing a broken ankle. I also found my physical therapist to be very knowledgeable about surgeries because she rehabs people before and after them and had knowledge of doctors and surgical procedures by treating their patients. Another source of evidence based information is medical literature and that can be found online. Sometimes, all you can see is the abstract, and other times, you can find a complete paper available without having to pay to read it. On the Mayo website, publications are listed in the physician profiles and you can look at those online. You can always search for a surgeon online and may find research papers if they are publishing. I think surgeons at major medical centers are the ones leading new innovations their field and publishing rather than surgeons in private practices. Medical journals have peer review by experts in the field before a paper is published.

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Thank you for your response. I cannot count the number of physicians I have consulted, looking for a solution to chronic lumbar spine pain. I have many issues all delineated in two lumbar spine MRIs. The physicians all have great credentials and are at reputable teaching hospitals and their recommendations contradict each other. I do use google scholar to search for evidence based research on treatment options but it is hard to evaluate the quality of the research. I am trying to figure out my options. Thus far I've been told no surgery! yes surgery! no fusion! yes fusion. I've tried multiple rounds of physical therapy injections, etc, and so far nothing has helped. I've seen physiatrists who sent me to surgeons, physiatrists who recommend all kinds of treatments from MILD, to PRP, to peptides, medical marijuana etc. I would like to find someone that will tell me their best idea for treatment and provide a realistic assessment of success of the recommended treatment. After 6 years I finally asked my PCP what percent of her patients had successful back surgery. 50%. That would have been good to know. I know the problem with back surgery is once you've had it you've had it and things can definitely worsen. I suppose it's just a dream but I'd really like to find a surgeon who, after evaluating my imaging and symptoms provide a treatment plan and realistic evidence based possible outcomes so I can make the best decision.

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