Adult lumbar spondylolisthesis: Interspinous devices

As minimally invasive surgery has become increasingly popular, interspinous process devices (IPDs) have evolved beyond cases of simple focal spinal stenosis. Despite design differences, all IPDs aim to achieve indirect decompression of the nerve roots by enlarging the caliber of the neural foramina via distraction of the adjacent spinous processes. Whether IPDs reduce the risk of adjacent level stenosis compared to decompression and fusion for degenerative spondylolisthesis remains unclear. Ultimately, the paucity of high-quality, long-term, comparative, clinical studies precludes any strong recommendation for the use of IPDs for the treatment of degenerative spondylolisthesis.