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A literature review.To evaluate the mechanisms of action and effectiveness of interspinous distraction devices in managing symptomatic lumbar spinal pathology.Fusion operations have traditionally been used to manage many disorders of the lumbar spine related to deformity, pain, or instability. Concern over the long-term effects of fusion on adjacent segments has led to the development of the concept of dynamic stabilization.A Medline search was performed using the key words “interspinous implants,” “interspinous devices,” and “lumbar dynamic stabilization.” The abstracts of each were reviewed. Relevant articles were reviewed in detail and other appropriate references obtained. In addition, when available, nonpublished manufacturer’s information was reviewed.Articles describing the following implants were included in this review: the Minns Device, the Interspinous “U,” the Diam, the Wallis Implant, and the X STOP.These devices continue to be evaluated in clinical trials. Early results suggest a possible role in the management of degenerative disorders of the lumbar spine.