Up to 84% of the US population may experience lower back pain in their lifetime, with degenerative lumbar spinal stenosis being a common cause in the elderly, leading to pain and reduced quality of life. In the United States, over 200,000 patients are affected, making lumbar spinal stenosis the leading reason for spinal surgery in those over 65. To avoid open surgery, procedures such as the minimally invasive lumbar decompression (MILD) procedure (Vertos Medical) have been developed to treat spinal stenosis by reducing hypertrophied ligamentum flavum without major incisions or prolonged recovery. Our study examines the effects of the MILD procedure on pain and function over 12 months.