A growing number of interspinous process devices are currently under investigation. No long-term results are currently available for the X-STOP spacer, but short-term and midterm results are promising.The X-STOP spacer is a good alternative to decompression surgery in elderly patients with moderate spinal stenosis without spondylolisthesis or severe osteoporosis. Further prospective controlled randomized studies comparing the X-STOP with decompression surgery must be done to clearly define the indications and to allow prediction of long-term results.