John C. Chiu: Treatment Of Lumbar Spinal Stenosis With Interspinous Process Decompression System (IPD) (X-Stop®). The Internet Journal of Minimally Invasive Spinal Technology. 2007. Volume 1 Number 1.
Lumbar spinal stenosis is most common reason for back surgery in patients over the age of 50 in America. With increased life expectancy, and the aging of baby boomers, many patients suffering from progressive lumbar spinal stenosis with symptomatic intermittent neurogenic claudication (NIC) have been limited to a choice between non-surgical therapies and more traumatic decompressive surgical procedure, with or without lumbar fusion. The interspinous process decompression system (IPD) (X-STOP®) implant was developed to provide a minimally invasive alternative therapeutic treatment of lumbar spinal stenosis.
The X-STOP® interspinous process decompression system, surgical indications, operative techniques, case illustrations, outcome and the potential complications and their avoidance are described and discussed herein.

A non-surgical approach to the management of lumbar spinal stenosis: A prospective observational cohort study Donald R Murphy, Eric L Hurwitz, Amy A Gregory, and Ronald Clary
BMC Musculoskelet Disord. 2006; 7: 16. Published online 2006 February 2
While it is widely held that non-surgical management should be the first line of approach in patients with lumbar spinal stenosis (LSS), little is known about the efficacy of non-surgical treatments for this condition. Data are needed to determine the most efficacious and safe non-surgical treatment options for patients with LSS. The purpose of this paper is to describe the clinical outcomes of a novel approach to patients with LSS that focuses on distraction manipulation (DM) and neural mobilization (NM).
Conclusion - A treatment approach focusing on DM and NM may be useful in bringing about clinically meaningful improvement in disability in patients with LSS.

these patients are limited to a choice between nonsurgical conservative care and more invasive decompressive surgical procedures such as laminectomy with or without fusion. The X STOP interspinous process decompression system is a commercially available device that provides a minimally invasive alternative treatment, an intermediate option within the continuum of care for these patients.

Bilateral Decompressive Surgery in Lumbar Spinal Stenosis Associated With Spondylolisthesis: Unilateral Approach and Use of a Microscope and Tubular Retractor System
from Neurosurgical Focus Posted 09/09/2002
Sylvain Palmer, M.D., Robert Turner, M.D., and Rosemary Palmer, R.N.
Abstract Object: The objective of this study was to assess the feasibility and efficacy of treating spondylolisthesis-related spinal stenosis via unilateral approach bilateral decompression in which METRx-MD instrumentation is placed.
Conclusions: By following the authors' procedure, minimally invasive bilateral decompression of acquired spinal stenosis associated with spondylolisthesis can be successfully performed on an outpatient basis, with reasonable operative times, minimal blood loss, and acceptable morbidity.

Review of methods of laminectomy for spinal stenosis compared to bilateral foraminal and nerve root decompression with preservation of the midline structures. The author suggests that this method of treatment is preferred

J Korean Neurosurg Soc 37 : 410-415, 200
Yong-Cheol Ji, M.D., Young-Baeg Kim, M.D., Sung-Nam Hwang, M.D., Seung-Won Park, M.D., Jeong-Taik Kwon, M.D., Byung-Kook Min, M.D. Department of Neurosurgery, College of Medicine, Chung-Ang University, Seoul, Korea Objective : The aim of our study is to evaluate the effectiveness of unilateral hemilaminectomy for bilateral decompression in elderly patients with degenerative spinal stenosis. For this purpose, we studied the co-morbid condition and clinical outcome of patients who underwent decompressive surgery using the unilateral approach technique.
Conclusion : Unilateral laminectomy for bilateral decompression, in spite of the limited exposure, can result in satisfactory decompression of the lumbar spinal stenosis and tolerable clinical outcome. This approach is thought to be appropriate for elderly patients who have a greater surgical burden.

Archive copy 2003

Full text is available for most of these.

Neurosurg Focus 9(4), 2000. © 2000
Stenosis of the thoracic spinal canal is a relatively rare disorder with numerous causes. Clinical manifestations include signs and or symptoms consistent with focal thoracic radiculopathy and/or myelopathy. Several surgical approaches for the decompression of the stenotic thoracic canal have been described. Laminectomy is typically reserved for only those cases in which dorsal compression of the neural elements is demonstrated; it is contraindicated when the epidural compression is primarily ventral in location.
Iain H. Kalfas, M.D., F.A.C.S. Section of Spinal Surgery, Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio

Pathogenesis, Presentation, and Treatment of Lumbar Spinal Stenosis Associated With Coronal or Sagittal Spinal Deformities
from Neurosurg Focus 14(1), 2003. Posted 02/13/2003
Justin F. Fraser, B.A., Russel C. Huang, M.D., Federico P. Girardi, M.D., Frank P. Cammisa, Jr., M.D.
The purpose of this paper is to review the pathogenesis, presentation, and treatment of lumbar spinal stenosis complicated by scoliosis, spondylolisthesis, or flat-back deformity. Specific attention is paid to surgery-related goals, decision making, techniques, and outcomes.

onsultant orthopaedic and spinal surgeon M H Hilali Noordeen looks at the latest clinical trials using the X STOP. It is one of the latest implants for the treatment of moderate lumbar spinal stenosis.

Patient Information. Lumbar stenosis is a narrowing of the spinal canal in the lower part of the spine. This narrowing places pressure on the spinal cord and/or nerves. While some patients are born with this narrowing, most cases of lumbar stenosis occur in patients over the age of 50 and are the result of aging and "wear and tear" on the spine.

EFORT ICL (1995) published in JBJS Vol 78-B #1 Jan 1996 p 154

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Bibliography from Spinalstenosis.org
Last updated 2004