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 your spinal stenosis. IPD reflects the tremendous advances made in minimally invasive spine surgery. IPD is sometimes performed as an alternative to decompression spine surgery, such as a laminectomy.
IPD involves an implant (called a spacer) made from titanium alloy. This implant is inserted as a spacer between your spinous processes.
As you can see in the image below, 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.
Benefits of Interspinous Process Decompression
The most important benefit of IPD is that your surgeon creates more space for your spinal cord and nerves in your spinal canal without removing any of your bone (as in a traditional laminectomy) and with less trauma to your muscles and ligaments.
Other benefits of interspinous process decompression:
- Helps preserve some motion in your spine (Fusion can limit how well you can move, but the IPD implant can help you maintain some motion.)
- Less blood loss
- Less risk of infection
- Can be done on an outpatient basis
When Is Interspinous Process Decompression Used?
Interspinous process decompression is used to treat lumbar spinal stenosis, a condition in your low back that causes your spinal canal to become narrow.
How the Interspinous Process Decompression Is Done
For this procedure, you'll be lying on your side or stomach, and your surgeon will give you general anesthesia or local anesthesia.
Your surgeon will use fluoroscopic guidance (a fluoroscope is a special type of x-ray) during your surgery and will make one 2- to 3-inch incision in your low back. Then, your surgeon will place an implant (one example is the X-STOP implant) between 2 of your vertebrae. This implant can be placed at 1 or 2 levels of your spine.
After the implant is inserted, your doctor will close up the surgical site.
IPD takes 15 to 45 minutes to perform.
Interspinous Process Decompression Risks
Even though IPD does not require removing your bone or cutting your muscles or tissues, there are still risks for this procedure:
- Implant can become dislodged or moved out of place.
- The bones may settle around the implant, which is a very common risk in people who have osteoporosis.
- Your spinous process can fracture when the surgeon inserts the IPD spacer.
- Implant may not provide enough relief.
- You may need additional surgery to relieve pain and other symptoms.
Furthermore, certain patients are not candidates for IPD. These patients include those who have:
- 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.