Aim. To improve the results of surgical treatment of lumbar spine stenosis. Materials and methods. Surgical treatment of 84 patients was analyzed. There were 2 groups consisting of 48 and 36 patients respectively. Advanced decompression and fusion were performed in group 1, minimally invasive decompression (flavectomy, marginal arch resection, facetectomy) with implantstion of interspinous dynamic implants DIAM - in group 2. Patients with isthmic spondylolisthesis were excluded. Results and discussion. Both methods did not show difference in efficacy of leg pain relief during follow-up (1.7-8.5 years). 16.7% of patients after fusion of more than 2 segments had pain above and below fusion area in long-term postoperative period. Such pain was not observed in group 2. One patient of the 1st group had fixation system destruction that required repeated intervention. Groups have not difference in back pain severity after surgery on 1 segment. Also less intraoperative blood loss and duration of surgery were established in group 2. Conclusion. Minimally invasive decompression with implantstion of interspinous dynamic implants is effective and safe alternative to advanced decompression and fusion in lumbar spine stenosis management.