{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:04:44Z","timestamp":1790391884513,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,6,22]],"date-time":"2012-06-22T00:00:00Z","timestamp":1340323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p><jats:bold>Abstract:\u2002<\/jats:bold> Lumbar spinal stenosis (LSS) is characterized by narrowing of the spinal canal with impingement of the spinal cord by surrounding tissues of bones. Current management options for LSS include rest, medications, physical therapy, epidural steroid injections, alternative medicine, and surgical decompression. Because each modality of treatment has its own set of limitations, there is a need for a safe, effective, and cost\u2010saving treatment for LSS. <jats:italic>mild<\/jats:italic> is a minimally invasive procedure for treatment of degenerative LSS with ligamentum flavum hypertrophy through percutaneous decompression of the hypertrophic ligamentum flavum. The effect is debulking of tissue that is a contributor to lumbar canal narrowing with minimal trauma to surrounding tissue. This literature review presents a brief review of the pathophysiology, clinical presentation, and current treatment options for LSS and reviews the current literature regarding the efficacy, safety, and cost\u2010effectiveness of the <jats:italic>mild<\/jats:italic> procedure.<\/jats:p>","DOI":"10.1111\/j.1533-2500.2012.00574.x","type":"journal-article","created":{"date-parts":[[2012,6,22]],"date-time":"2012-06-22T18:44:41Z","timestamp":1340390681000},"page":"146-153","source":"Crossref","is-referenced-by-count":13,"title":["<i>mild<\/i> Procedure for Lumbar Decompression: A Review"],"prefix":"10.1111","volume":"13","author":[{"given":"Hamilton","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Kelling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,6,22]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp0708097"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199505150-00013"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-009-9051-x"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000188117.77657.ee"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199609010-00024"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199503150-00003"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2009.11.001"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-7-200210010-00010"},{"key":"e_1_2_8_10_2","doi-asserted-by":"crossref","first-page":"31","DOI":"10.3233\/BMR-2010-0245","article-title":"Physical therapy treatment options for lumbar spinal stenosis","volume":"23","author":"Tomkins CC","year":"2010","journal-title":"J Back Musculoskelet Rehabil"},{"key":"e_1_2_8_11_2","first-page":"59","volume-title":"Evidence Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis","author":"North American Spine Society","year":"2007"},{"key":"e_1_2_8_12_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.2106\/00004623-198567010-00009","article-title":"The use of epidural steroids in the treatment of lumbar radicular pain. A prospective, randomized, double\u2010blind study","volume":"67","author":"Cuckler JM","year":"1985","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B3.15338"},{"key":"e_1_2_8_14_2","doi-asserted-by":"crossref","first-page":"343","DOI":"10.36076\/ppj.2010\/13\/343","article-title":"Evaluation of the effectiveness of lumbar interlaminar epidural injections in managing chronic pain of lumbar disc herniation or radiculitis: a randomized, double\u2010blind, controlled trial","volume":"13","author":"Manchikanti L","year":"2010","journal-title":"Pain Physician"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000158953.57966.c0"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199608010-00012"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200003010-00005"},{"key":"e_1_2_8_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53254.x"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000251014.81875.6d"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.20.2441"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199201000-00001"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199601010-00022"},{"key":"e_1_2_8_23_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.36076\/ppj.2010\/13\/35","article-title":"New image\u2010guided ultra\u2010minimally invasive lumbar decompression method: the mild procedure","volume":"13","author":"Deer TR","year":"2010","journal-title":"Pain Physician"},{"key":"e_1_2_8_24_2","doi-asserted-by":"crossref","first-page":"369","DOI":"10.36076\/ppj.2010\/13\/369","article-title":"MiDAS I (mild\u00ae decompression alternative to open surgery): a preliminary report of a prospective, multi\u2010center clinical study","volume":"13","author":"Chopko BC","year":"2010","journal-title":"Pain Physician"},{"key":"e_1_2_8_25_2","unstructured":"CarawayD.MiDAS I: 12\u2010week follow\u2010up of a prospective open label multi\u2010center clinical study. Presented at ASIPP Conference;2010."},{"key":"e_1_2_8_26_2","unstructured":"BrownLL.mild vs ESI prospective randomized double\u2010blind crossover. Presented at AAPM Conference;2010."},{"key":"e_1_2_8_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2011.00518.x"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1533-2500.2011.00481.x"},{"key":"e_1_2_8_29_2","unstructured":"BrownLL.Six\u2010week follow\u2010up of patients treated withmild\u2014prospective single center results. Presented at ISIS Conference;2010."},{"key":"e_1_2_8_30_2","unstructured":"DeerTR.mild: percutaneous decompression laminotomy single center outcomes. Presented at ISIS Conference;2011."},{"key":"e_1_2_8_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31822bb344"},{"key":"e_1_2_8_32_2","unstructured":"DeerT.mild\u2010Long term outcomes with percutaneous decompression. Presented at AAPM Conference;2010."},{"key":"e_1_2_8_33_2","first-page":"555","article-title":"Retrospective review of patient self\u2010reported improvement and post\u2010procedure findings for mild (minimally invasive lumbar decompression)","volume":"13","author":"Lingreen R","year":"2010","journal-title":"Pain Physician"},{"key":"e_1_2_8_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/197140091102400419"},{"key":"e_1_2_8_35_2","unstructured":"GrisbyE.mildprocedure for the treatment of lumbar spinal stenosis: procedure description & safety. 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