Neurogenic claudication
Symptoms such as leg pain, heaviness, numbness, or weakness are provoked by standing or walking and typically improve with sitting or flexion.
MILD® PROCEDURE
A minimally invasive treatment for lumbar spinal stenosis.
The mild® Procedure is a minimally invasive, image-guided lumbar decompression treatment for appropriately selected patients with lumbar spinal stenosis and neurogenic claudication related in part to thickened ligamentum flavum.
LUMBAR SPINAL STENOSIS
Spinal stenosis can limit more than comfort.
Lumbar spinal stenosis occurs when the spinal canal becomes narrowed. One contributor can be hypertrophy, or thickening, of the ligamentum flavum. When narrowing compresses the nerves, patients may develop neurogenic claudication—pain, heaviness, numbness, or weakness in the legs that often worsens with standing or walking.
Symptoms often improve with sitting, bending forward, or resting. Imaging helps define the degree and contributors to stenosis, but the decision to consider mild® depends on the patient’s symptoms, examination, imaging, prior treatment, and overall clinical picture.
PATIENT SELECTION
Who may be a candidate?
The mild® Procedure is intended for a specific subset of patients with symptomatic lumbar spinal stenosis. Careful selection is important because stenosis can result from several different anatomic factors.
Compatible imaging
Lumbar imaging demonstrates central canal narrowing with hypertrophic ligamentum flavum contributing meaningfully to the stenosis.
Persistent functional limitation
Symptoms continue to limit walking, standing, or daily activity despite an appropriate course of nonsurgical care.
Anatomic fit
The clinical evaluation considers other contributors to stenosis and whether a different treatment would better address the patient’s anatomy and symptoms.
THE PROCEDURE
How the mild® Procedure works.
Using fluoroscopic guidance, specialized instruments are introduced through a small access point in the back. Small portions of hypertrophic ligamentum flavum and adjacent tissue are removed to increase space within the lumbar spinal canal.
The goal is to reduce one of the contributors to central canal narrowing while preserving the overall structure of the spine. The procedure does not involve placement of an implant.
EVIDENCE & EXPECTATIONS
Clinical evidence in appropriately selected patients.
Randomized clinical trials and longer-term follow-up studies have demonstrated improvements in walking tolerance, pain, and function after the mild® Procedure in appropriately selected patients with lumbar spinal stenosis and neurogenic claudication related to hypertrophic ligamentum flavum. Individual outcomes vary, and treatment is considered only when the clinical picture and imaging support an appropriate indication.
Diagnosis firstmild® is not a treatment for every cause of lumbar spinal stenosis.
Selection mattersSymptoms, examination, imaging, and prior treatment are considered together.
Function mattersThe goal is meaningful improvement in walking, function, pain, and quality of life.
WHAT TO EXPECT
A plan built around the diagnosis.
Before treatment
Your evaluation includes a review of symptoms, prior treatment, examination findings, and lumbar imaging to determine whether neurogenic claudication from lumbar spinal stenosis is a reasonable diagnosis and whether ligamentum flavum hypertrophy is an important contributor.
Procedure day
The mild® Procedure is performed using fluoroscopic guidance through a small access point in the back. Procedure-specific instructions regarding medications, eating or drinking, transportation, and arrival time are provided in advance.
After treatment
Recovery and activity guidance are individualized. Follow-up is used to assess walking tolerance, leg symptoms, pain, function, and overall progress.
FREQUENTLY ASKED QUESTIONS
Common questions about the mild® Procedure.
Is the mild® Procedure the same as spine surgery?
No. The mild® Procedure is a percutaneous, image-guided decompression treatment performed through a small access point. It does not involve an open incision, spinal fusion, or placement of an implant.
What is neurogenic claudication?
Neurogenic claudication refers to leg symptoms caused by lumbar spinal stenosis. Patients commonly describe pain, heaviness, numbness, tingling, or weakness that worsens with standing or walking and improves with sitting or bending forward.
Does having spinal stenosis mean I need the mild® Procedure?
No. Lumbar spinal stenosis can have several causes and ranges widely in severity. Imaging is only one part of the evaluation, and treatment should be matched to the patient’s symptoms, anatomy, prior care, and goals.
How quickly will I know whether it helped?
Response varies from patient to patient. Follow-up is used to assess changes in walking tolerance, leg symptoms, pain, function, and overall progress after treatment.
Is the mild® Procedure appropriate for every patient with lumbar spinal stenosis?
No. The procedure is intended for appropriately selected patients whose symptoms and imaging are consistent with lumbar spinal stenosis and neurogenic claudication, with hypertrophic ligamentum flavum contributing to the narrowing. A focused evaluation is needed to determine whether it is an appropriate option.
NEXT STEP
Could spinal stenosis be limiting your walking?
A focused evaluation can help determine what is contributing to your symptoms and whether the mild® Procedure may be an appropriate treatment option.
Request an AppointmentThis page provides general educational information and does not replace an individualized medical evaluation. Treatment recommendations, risks, benefits, alternatives, and expected recovery vary by patient and should be reviewed as part of an individualized treatment discussion.