Interspinous process distraction

One device aimed at obtaining an interspinous process distraction is the X-Stop (St. Francis Medical Technologies, San Francisco, Calif., USA) and is currently undergoing a prospective study for possible United States Food and Drug Administration approval. Biomechanical studies have shown an unloading of the disc at the instrumented

Fig. 2 a Preoperative standing upright lateral radiographic view of a degenerative spine. b Postoperative standing upright view with the X-Stop placed between the spinous processes. Note the enlarging of the foramen

level with no effect at adjacent levels [28]. This device is implanted between the spinous processes thus reducing extension at the symptomatic level(s) bt allows flexion and unrestricted axial rotation and lateral flexion (Fig. 2). The major portion of the interspinous ligament is preserved. It is indicated in patients in whom the symptoms are increased in extension. In a prospective, randomized, multicenter study Zuckerman et al. [35] showed a success rate at 1 year of 59% with X-Stop compared to 12% in the conservative treatment control group.

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