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Treatments · Kyphoplasty, MILD, Botox & VIA Disc

MILD lumbar decompression in Abilene, Texas

Lumbar spinal stenosis narrows the spinal canal, often because the ligament at the back of the canal has thickened. The result is leg pain, heaviness, or numbness that comes on with standing and walking and eases when you sit or lean forward. MILD removes the excess ligament through an incision smaller than a baby aspirin.

Imaging

Live X-ray (fluoroscopy)

Comfort

Local numbing with light sedation

Time

Under an hour

Home

Same day

How it works

What it is, and why it works.

What it is · Minimally invasive lumbar decompression for spinal stenosis caused by a thickened ligament, performed through a tiny incision with no implants and no general anesthesia.

Why it's effective · Removing the excess ligament restores space in the spinal canal, easing the leg pain and heaviness that force you to stop and lean forward while walking. It addresses the cause rather than only the symptom, with a safety profile similar to an epidural injection.

Using live X-ray, specialized instruments remove small pieces of excess ligament and bone through a tiny incision, unclogging the canal and relieving pressure on the nerves of the lower back. There are no stitches, no general anesthesia, and no hardware left behind; the incision is closed with an adhesive bandage.

For patients whose walking distance is limited by leg heaviness that improves when they lean forward, MILD sits between repeated injections and open surgery. Where an interspinous spacer is the better fit, we discuss that option as well.

Who it is for

Lumbar spinal stenosis with neurogenic claudication

Leg pain, heaviness, or numbness that worsens with standing or walking and eases with sitting or leaning forward, with imaging showing a thickened ligamentum flavum.

Patients who want to avoid or delay open surgery

No general anesthesia, no stitches, and no implant, with most patients back to light activity within a day.

When a spacer fits better

An interspinous spacer is a small implant placed between the vertebrae for the same condition. We choose between the two based on your anatomy and imaging.

Who it helps

The conditions we most often treat this way.

Every plan starts with a diagnosis, not a procedure. Your first visit is an evaluation of your history, exam, and imaging, and we tell you what we believe is generating your pain before any treatment is scheduled. What the first visit is like →

Lumbar Spine & Low Back Pain

Spinal stenosis and neurogenic claudication

What to expect

Before, on the day, and afterward.

Before

  • Our office will tell you which medications to hold and for how long, following the same blood-thinner guidelines as our other spine procedures.
  • Nothing to eat or drink for six hours beforehand, since light sedation is used. Essential morning medications may be taken with a sip of water.
  • Bring a responsible adult to drive you home.

Procedure day

  • Performed under live X-ray with local numbing and light sedation. The procedure typically takes less than an hour.
  • The tiny incision is closed with an adhesive bandage. You go home the same day.

Afterward

  • Many patients notice an improvement in standing and walking distance within days as the nerves recover. Mild soreness or a bruised feeling around the incision is normal for two to five days; ice packs help, and NSAIDs and aspirin may be resumed immediately.
  • Resume light indoor activity right away, and walking is encouraged. Keep lifting under 15 pounds and avoid strenuous activity or twisting for one week. Keep the site clean and dry for two days; shower after 24 hours, no baths or pools for seven. We see you at about two weeks and again at three months to measure walking distance and function.

Call us right away if you notice

  • New or worsening leg weakness, numbness, or foot drop
  • Sudden loss of bowel or bladder control
  • Fever above 101.5°F, chills, or drainage at the site
  • A severe headache that worsens when sitting or standing

Call or text 325-326-3433. In an emergency, call 911.

Where it happens

Most of our image-guided procedures are performed in our own procedure suite at 1925 Hospital Place. When a case calls for a hospital or surgery center, we arrange it and remain your physicians throughout. Your appointment paperwork tells you which facility and when to arrive.

Full preparation and discharge details are in the handout below and in the general procedure guide (PDF).

The evidence

What the published data say.

All the evidence →

MILD — minimally invasive lumbar decompression

Level I

Lumbar spinal stenosis with ligamentum flavum hypertrophy · neurogenic claudication

A randomized controlled trial comparing MILD with epidural steroid injection found significantly greater improvement in function and pain at one year, sustained at two years in follow-up, with a safety profile comparable to injection and no reported device-related complications.

Staats PS, et al. MiDAS ENCORE: randomized controlled clinical trial report of 6-month results. Pain Physician. 2016; and Benyamin RM, et al. Pain Physician. 2016.

For you · If walking is limited by leg heaviness that eases when you lean forward, this can restore walking distance without an implant, general anesthesia, or a hospital stay.

Interspinous spacers & MILD decompression

Level I–II

Lumbar spinal stenosis with neurogenic claudication

Randomized and prospective comparative studies of the Superion interspinous spacer and of minimally invasive lumbar decompression show durable improvement in walking distance and leg symptoms in appropriately selected patients, without open surgery.

Patel VV, et al. Superion interspinous spacer versus X-STOP for moderate lumbar spinal stenosis: randomized controlled trial. Int J Spine Surg. 2015. · Staats PS, et al. MOTION study: MILD versus conventional medical management. Pain Pract. 2018.

For you · If you can only walk a short distance before your legs give out, there are options between injections and a laminectomy.

Common questions

Answers before you call.

It is a minimally invasive procedure rather than open surgery. There is no general anesthesia, no stitches, and no implant, and its safety profile is similar to an epidural steroid injection. It is performed through an incision smaller than a baby aspirin.

Your handout

The same guide we hand you in the office.

How to prepare, what happens on the day, and the discharge instructions for afterward. Download it, or send it to yourself to read at home.

Send it to yourself

Every handout is listed on the Your Procedure page.

MILD procedureRead the guide →PDF ↓
Interspinous spacer deviceRead the guide →PDF ↓

Ready to talk about your pain?

New patients are generally seen by referral. Ask your provider to fax records and imaging to 325-378-9175, or text us with a question first.

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