Interspinous Process Decompression

Interspinous process decompression is a minimally invasive procedure that places a small spacer inside the spine to separate adjacent vertebrae. It keeps pressure off nerves that cause leg and back pain associated with lumbar spinal stenosis.

This procedure usually takes place at an outpatient surgery center. Most patients return home on the same day.

What is interspinous process decompression?

Interspinous process decompression is a minimally invasive procedure designed to relieve leg and back pain associated with lumbar spinal stenosis.

Lumbar spinal stenosis is the gradual reduction of the space where nerves pass through the spine. As these spaces narrow, they can cause a pinching of the nerves in the lower back. The outcome could be a dull, aching pain in the lower back that radiates to the buttocks and lower limbs.

A doctor places small spacer between two adjacent spine vertebrae in the interspinous process decompression procedure. This ensures the space permanently remains open and doesn’t continue to pinch the pain-causing nerves. This can help to reduce pain and restore mobility.

Medical Term Breakdown

• “Interspinous” means located between spines, in this case, between the adjacent vertebrae of the spine.
• “Process” refers to the bony projection off the back of each spinal vertebra.
• “Decompression” in surgery indicates a procedure to remove pressure on a structure, in this case, two adjacent vertebrae.

Who is a good candidate for interspinous process decompression?

Good candidates for interspinous process decompression are individuals who have chronic back pain from lumbar spinal stenosis.

Neurogenic claudication is a significant indication of lumbar spinal stenosis. This refers to dull, aching leg pain that encompasses the buttocks, groin, and front of the thigh. It also includes pain radiating down the back of the leg to the feet.

This pain usually becomes worse when standing or walking. It improves when sitting, standing, or leaning forward in a flexed position.

Candidates should have exhausted conservative treatment alternatives such as physical therapy, anti-inflammatory medications, lumbar corsets, and therapeutic injections. A doctor might recommend interspinous process decompression if this conservative management fails to provide adequate relief.

Interspinous process decompression can be a safe and effective alternative when laminectomy or spinal fusion is too aggressive.

Why might someone not be a good candidate for interspinous process decompression?

When considering this procedure, your doctor will review a patient’s medical history and their imaging.

A patient may not undergo this procedure:

• If they are allergic to the implant material, often made of titanium or a titanium alloy.
• If they have spinal anatomy issues like severe scoliosis or diseases that cause lumbar spine vulnerability.
• If they are morbidly obese, this implant is not stable enough to support that body mass index (BMI) level.
• If they have an active systemic infection or an infection at the implant site.

How is the interspinous process decompression procedure done?

Interspinous process decompression is a minimally invasive outpatient surgical procedure performed under local anesthesia and sedation.

First, a doctor makes a small incision in the patient’s back. The doctor then uses fluoroscopic guidance to position and implant a small spacer between the vertebrae. The doctor then closes the incision to complete the procedure.

The procedure generally takes less than 1 hour. Normally a patient can go home the same day unless they experience complications.

What are the risks or possible complications of interspinous process decompression?

All surgeries have risks, even minimally invasive surgeries. Any surgery risks blood loss, a reaction to the anesthetic, and pain and discomfort after the procedure.

Potential complications of the interspinous process decompression procedure include:

• A patient may be sensitive or have an allergic reaction to the implant, often a titanium or titanium alloy.
• Following the procedure, the spacer could fail to deliver sufficient relief from pain and symptoms.
• The implant may dislodge or move.
• Bone may settle around the implant, most commonly in osteoporosis patients.
• The spinous process may fracture.

What are the benefits of interspinous process decompression?

Interspinous process decompression is a clinically proven, minimally invasive solution. It can deliver long-term relief from the leg and back pain associated with lumbar spinal stenosis.

A doctor will implant spacers without removing any structural bone during the procedure, preserving the spine’s natural anatomy. Therefore, if a patient and their doctor decide to later remove a spacer, natural spine anatomy remains intact.

Thus, the spacers procedure may allow patients and their doctors to consider alternative treatments later if the spinal condition progresses.

How long does it take to recover from an interspinous process decompression procedure?

Everyone is unique, so recovery times may vary. However, most patients go home within hours of the procedure, normally done in an outpatient setting.

What precautions should I take after an interspinous process decompression procedure?

After the procedure, a patient’s doctor will advise them to initially limit their activity and gradually increase light physical tasks. It is crucial for patients to be cautious and avoid excessive activity in the early post-procedure stages.

Following the procedure, patients must avoid any lifting, bending, or strenuous activity for six weeks. They should not subject their back to too much strain by lifting weights over ten pounds.

Patients should also avoid significant bending of the spine, twisting, and strenuous activities. These include swimming, golf, tennis, racquetball, running, jogging, or sexual activity.