Low back pain is exceptionally ubiquitous, complex, and costly. Nevertheless, lumbar
spinal stenosis (LSS) with neurogenic intermittent claudication (NIC) is a frequent cause
of low back and lower extremity pain. Although the phenomena and pathophisiology
of lumbar spinal stenosis has been described for decades, therapeutic treatment
options remain considerably limited.
Current care consists of conservative measures including physical therapy, rest,
medications, and epidural steroid injection therapy or invasive surgical treatment
including laminectomy with or without fusion. Despite standard of care intervention,
many patients are often left inadequately treated and suffer from debilitating low back
and lower extremity pain as a result of lumbar spinal stenosis. Interspinous process
distraction (IPD) devices were originally described in the 1950s, but technological
advances, which have contributed to improved safety and efficacy, have rekindled an
interest in IPD implantation. By mimicking lumbar flexion at affected levels of stenosis,
it is thought these devices decompress neural structures within the neural foramina
and therefore provide pain relief. X-STOP is one such device that is currently approved
in the United States for the treatment of mild to moderate NIC resulting from LSS.
This manuscript presents a focused review of NIC and LSS and comprehensively
presents literature related to the use of the X-STOP IPD device.
Key words: Interspinous process distraction (IPD), X STOP, interspinous spacer (ISS),
lumbar spinal stenosis (LSS), neurogenic intermittent claudication (NIC), low back
pain, sciatica
The efficacy of lumbar sympathetic nerve block for neurogenic intermittent claudication in lumbar spinal stenosis
