Interspinous Process Decompression

Minimally Invasive Spinal Stenosis Surgery

Interspinous process decompression (IPD) is a minimally invasive procedure that spine surgeons use today to try to relieve symptoms of lumbar spinal stenosis. IPD reflects the advances made in minimally invasive spine surgery, and is sometimes performed as an alternative to decompression spine surgery, such as a laminectomy.

IPD involves implanting a device called a spacer or interspinous spacer. This implant is inserted between the spinous processes. Spinous processes are the thin, bony projections on the back of the spine. When you run your hand over your spine, you can feel the spinous processes.
labeled structures of a lumbar, low back vertebral segmentImportant anatomical structures of a lumber vertebral segment are illustrated and labeled, including the spinous process. Photo Source: Shutterstock.

Potential Benefits of Interspinous Process Decompression

An important potential benefit of IPD is the spacer creates more space for your spinal cord and nerves in your spinal column without removing any bone (as in a traditional laminectomy) and with less trauma to your muscles and ligaments.

Other IPD benefits include:

  • Helps preserve some spinal motion (unlike spinal fusion that permanently limits movement)
  • Less blood loss
  • Reduced risk for infection
  • IPD can be performed in an outpatient surgical facility

How Interspinous Process Decompression is Performed

For this procedure, the patient is positioned face down on their stomach. The anesthesiologist administers a local anesthetic and/or general anesthesia.

Using fluoroscopic guidance (real time imaging), the surgeon makes one small incision in your low back and implants the IPD spacer between two spinous processes (eg, L4-L5). The surgical incision is closed. The procedure takes 15 to 45 minutes to perform depending on whether one or two spacers are implanted.

Potential Risks Related to Interspinous Process Decompression

Although IPD does not require removing  bone or cutting muscles or other soft tissues, there are risks.

  • Implant can become dislodged or moved out of place
  • Bone may settle around the implant, which is a  common risk in people with osteoporosis
  • The spinous process can fracture when the IPD spacer is implanted
  • After implantation, the spacer may not provide adequate relief from pain and symptoms
  • You may need additional surgery to relieve pain and other symptoms

Specific patients are not candidates for IPD; such as patients with the following:

  • Severe bowel or bladder dysfunction, which can be a symptom of cauda equina syndrome (when the nerve roots in your low back are severely compressed, which can permanently affect your movement and sensation)
  • significant weakness
  • severe osteoporosis
  • an infection
  • an allergy to titanium

Interspinous Process Decompression Recovery

Recovery from IPD typically includes some soreness after the surgery. Your doctor may tell you to limit your activities—vigorous exercise, bending backward, heavy lifting, climbing stairs—for several weeks after your surgery.

However, comfortable, gentle movement, such as light walking, is encouraged. Your doctor may also recommend physical therapy, which involves gentle strengthening and stretching exercises, to help you recover as quickly as possible from interspinous process decompression.

Updated on: 09/10/19
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