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Minimally Invasive Lumbar Decompression

According to the Journal of Neurosurgical Review, more than 1.2 million people a year receive treatment for lumbar spinal stenosis (LSS). Those people typically suffer from low back pain and have discomfort when they stand or walk for a while. The condition is common for older people and often results in ambulation problems, sensory disturbance, muscular weakness and increasing leg and back pain. Treatment usually begins with exercise, medications, rest and physical therapy. Pain doctors may perform epidural steroid injections if the low back pain persists.

There is a wide variation in the severity of LSS symptoms for different people, and when the conservative measures do not bring relief for lumbar spinal stenosis patients, doctors may recommend surgical decompression. Bones and soft tissues in the spine often become hard and overgrown as people age, which may result in spinal stenosis, a constricted spinal canal. A narrowing of the space around the spinal cord may inflict pressure on it and on its nerve roots and create inflammation, swelling, pain, leg weakness and numbness.

Surgery for lumbar stenosis has traditionally involved an open lumbar decompression with a hospitalization of one to three days and a recovery period of four to six weeks. The surgery usually takes one to three hours and requires making an incision in the back. The surgeon splits the back muscles, moves them aside to expose the lamina of the vertebra and relieves the compression using one of several techniques.

However, the development of a minimally invasive lumbar decompression (MILD) surgical procedure for treating lumbar spinal stenosis normally makes major surgery unnecessary in certain patients. The innovative, minimally invasive process can accomplish the goals of decompression with smaller incisions, less bleeding and faster recovery. Same-day dismissal is typical after the MILD procedure partly because less injury to bony structures and tissue surrounding the spine occurs.

Pain management doctors typically use IV sedation and local anesthesia to perform the minimally invasive lumbar decompression. X-rays are taken during the procedure to target the appropriate level for decompression. If the stenosis is more severe and covers a large area, the MILD surgery method may not provide enough visualization. In that case, the patient may need the open surgery technique to correct the condition.

MILD is a safe, outpatient procedure that is effective in helping lumbar spinal stenosi patients walk and stand longer with less pain. The process usually takes less than an hour and does not require general anesthesia, implants or stitches. A certified doctor makes a very small incision in the back and uses special tools and an imaging machine to extract tiny bone pieces and excess ligament tissue. The procedure reduces compression of the nerves by creating more space in the spinal canal, which restores mobility and decreases pain. After MILD surgery, most people enjoy a same-day return-home policy and can normally carry on with ordinary activities and light chores within several days.

Complications from MILD surgery are rare, but there are potential risks associated with any surgical procedures. Surgery risks include stroke, cardiac arrest, heart attack and embolism (fat or blood that travels to the heart or lungs). Less serious risks include bleeding, infection and injury to the spinal cord and nerves. Dr. Geula is one of handful of pain doctors in the Los Angeles area to be certified in this cutting-edge treatment for low back pain. Contact us today for more information.