In this minimally-invasive outpatient procedure, usually performed under local anesthesia and sedation, a titanium alloy device is implanted to relieve back pain and numbness in the legs caused by lumbar spinal stenosis. This procedure is an alternative to laminectomy or spinal fusion. The patient is placed face down or on her side, and the area is cleaned and sterilized. The procedure may be performed under general anesthesia, or with sedation and local anesthesia. A small incision is made in the lower back. An opening is created through the ligaments at the rear of the spine. The physician can now access the spinous processes, the bony protrusions on the back of the spine, above and below the damaged disc. Using fluoroscopic guidance, the surgeon uses a sizing distractor to create space between the spinous processes. The X‑STOP® implant is inserted through the incision and placed between the spinous processes. If the patient is conscious during the procedure, she may be asked to bend her back to create more space in the spine for the implant. The incision is closed with sutures and a bandage is applied. Patients typically can leave the hospital within 24 hours. Strenuous physical activity should be avoided for two to six weeks. Physical therapy may be required.