Pain Management Specialists -  - Board Certified Interventional Pain Management Physician

Pain Management Specialists

Board Certified Interventional Pain Management Physicians located in Rockville, MD & Frederick, MD

The mild® Procedure  (percutaneous interlaminar lumbar decompression) is a minimally invasive procedure that helps patients suffering from lumbar spinal stenosis . Stuart Hough, MD, and Ramani Peruvemba, MD, at Pain Management Specialists in Rockville and Frederick, Maryland, are fellowship-trained experts in the use of the mild® Procedure. Call the office nearest you or book an appointment online to learn more about the mild® Procedure.

What is the mild® Procedure?

Percutaneous interlaminar decompression, or the mild® Procedure, is a short outpatient, minimally invasive procedure that restores space in the spinal canal by removing tissue that is responsible for lumbar spinal stenosis. It does not require general anesthesia and is done through incisions which can be covered by bandaids.  It provides long-term pain relief for many patients suffering from spinal stenosis.

The doctors at Pain Management Specialists are trained and experienced in the use of mild® Procedure for patients with lumbar spinal stenosis.

Am I a candidate for the mild® Procedure?

Your board-certified pain management physician at Pain Management Specialists determines if you’re a candidate for the mild® Procedure after an evaluation.

People who are likely to respond well to the mild® Procedure have pain that radiates into one or both legs when walking and standing, and which is relieved by sitting. Many complain that they cannot shop at the grocery store without leaning on the cart. On MRI or CT scan of the lumbar spine, they have narrowing of the spinal canal at one or more levels (spinal canal stenosis) caused by thickening of the ligaments behind the spinal canal, which is the most common reason for lumbar spinal stenosis. The mild® Procedure can be used to treat spinal stenosis between the L2 and L5 vertebrae, where it most commonly occurs.

An MRI showing lumbar spinal stenosis due to ligamentum flavum hypertrophy

What happens during the mild® Procedure?

Your Pain Management Specialists doctor performs the mild® Procedure in an outpatient surgery center or hospital operating room with local anesthesia and sedation from an anesthesiologist. The procedure typically takes 20 to 30 minutes, depending on how many levels are being treated.

After numbing the skin and deeper tissues, your doctor makes a small (roughly 5 millimeter) incision on one side of your spine and inserts a metal tube (trocar) about the thickness of a drinking straw into the thickened ligament using X-ray guidance. After precisely positioning the trocar, another tool is inserted through it and used to remove excess ligament piece-by-piece. The procedure may then be repeated on the other side and at additional level(s) if needed. Typically one or two levels are treated from both sides, leaving you with two small incisions which are closed with surgical glue. After your mild® procedure, you will need to spend a short time in the recovery room before going home. You must arrange to have someone drive you home after the procedure.

The minimally invasive mild® Procedure has a safety profile similar to epidural steroid injections but with lasting results, and patients typically return to normal activity within 24 hours with no restrictions.* mild® is covered nationwide by Medicare (all ages, all plan types, including Medicare Advantage) the VA, U.S. Military & IHS. Commercial coverage varies.

Video demonstrating the  mild® Procedure

When will I feel pain relief after the mild® Procedure?

Pain after the mild® procedure is usually mild and temporary. Many patients start to experience relief of their usual symptoms between two and six weeks after the procedure. Studies have shown that the relief is durable for five years.

The Pain Management Specialists team has witnessed remarkable advances in the treatment of lower back pain in the last few years and has been on the forefront of offering the latest proven treatments to patients. They are among very few interventional pain management practices in the area trained to evaluate and treat patients with the Intracept Procedure. To learn more about the mild® Procedure and how it may alleviate your chronic low back pain, call Pain Management Specialists or book an appointment online today.