===== Titanium Interspinous Process Device =====

A '''titanium interspinous process device (IPD)''' is a minimally invasive spinal implant placed between the spinous processes of lumbar vertebrae. It is typically used to treat lumbar spinal stenosis, particularly in patients whose symptoms improve with spinal flexion.

==== Definition ====
A titanium interspinous process device is an implant made of titanium alloy, designed to act as a spacer between spinous processes, limiting spinal extension and decompressing neural elements.

==== Mechanism of Action ====
  * Limits lumbar extension.
  * Maintains or increases the interspinous distance.
  * Enlarges the neural foramina and central canal.
  * Reduces load on the facet joints and posterior annulus.

==== Indications ====
  * Lumbar spinal stenosis with neurogenic intermittent claudication.
  * Symptom relief in flexion.
  * Mild to moderate cases without significant instability.

==== Contraindications ====
  * Severe spinal instability or spondylolisthesis > Grade I.
  * Osteoporosis or poor bone quality.
  * Active local or systemic infection.
  * Known allergy to titanium (rare).

==== Common Devices ====
  * [[Coflex]]® (Paradigm Spine)
  * [[Superion]]® (Vertiflex)
  * [[DIAM]]™ (Medtronic)
  * (Note: [[X-STOP]]® was withdrawn from the market)

==== Advantages ====
  * Minimally invasive approach.
  * Preserves segmental motion.
  * Shorter recovery times.
  * Possible use under local anesthesia.

==== Complications ====
  * Fracture of the spinous process.
  * Device migration or loosening.
  * Infection.
  * Persistent or recurrent symptoms.