From the Research
Contraindications to the mild (Minimally Invasive Lumbar Decompression) procedure include active local or systemic infection, bleeding disorders or anticoagulant therapy that cannot be safely discontinued, spinal instability requiring fusion, severe central canal stenosis, significant disc herniation causing neural compression, previous surgery at the target level, and allergy to any materials used in the procedure. The procedure is also contraindicated in patients with certain anatomical variations that would make the procedure technically challenging or unsafe, such as severe scoliosis or abnormal laminar anatomy. Patients with cauda equina syndrome or rapidly progressive neurological deficits should not undergo mild as these conditions require more urgent surgical intervention. The mild procedure specifically targets lumbar spinal stenosis caused by ligamentum flavum hypertrophy, so patients whose symptoms stem primarily from other pathologies would not be suitable candidates.
These contraindications exist because the mild procedure has specific technical requirements and safety parameters - attempting the procedure in contraindicated cases could lead to complications including dural tears, nerve injury, bleeding, or procedure failure without symptom relief. According to the most recent and highest quality study available, 1, the mild procedure has demonstrated excellent efficacy and safety in properly selected patients, but it is crucial to carefully evaluate each patient's suitability for the procedure to minimize the risk of adverse outcomes.
Some key points to consider when evaluating a patient's suitability for the mild procedure include:
- The presence of any active infections or bleeding disorders that could increase the risk of complications
- The patient's anatomical characteristics, such as the presence of severe scoliosis or abnormal laminar anatomy
- The patient's medical history, including any previous surgeries or conditions that could affect the procedure's safety and efficacy
- The patient's overall health and ability to tolerate the procedure.
By carefully considering these factors and adhering to the established contraindications, healthcare providers can help ensure that patients undergo the mild procedure safely and effectively.