Mr Ben Okafor FRCS (Orth.)

Consultant Orthopaedic and Spinal Surgeon

What is degenerative disc disease?

As discs in the back lose their water content because of disease or age, they lose their height, bringing the vertebrae closer together. As a result, the nerve openings in the spine become narrow and the discs do not absorb the shocks as well, particularly when walking, running or jumping. Wear and tear, poor posture and incorrect body movements can weaken the disc and facets, causing degeneration. Disc degeneration not only causes back pain but may also cause functional problems such as tingling or numbness in the legs or buttocks, or difficulty walking. Doctors call this degenerative disc disease (DDD).

What is the DIAM  spinal stabilisation system?

The DIAM  spinal stabilization system implant is a dynamic stabilization product that can be used to treat low back pain and radiating leg pain. The core of the DIAM device is made of silicone, the outer mesh and tether are made of polyester and the crimp is titanium. The first DIAM device surgery was performed in 1997. Since then, thousands of cases have been performed.

What are the potential benefits?

When the DIAM procedure goes well, the patient may experience less pain and return to most of their normal activities.  The potential advantages of this type of surgery include:

  • relief of painful symptoms
  • restoration of disc height
  • increased spinal stability
  • controlled motion

What sort of patients are suitable for the DIAM stabilization procedure?

The DIAM device is suitable for use in skeletally mature patients (at least 18 years old), undergoing surgery of the lumbar spine for arthropatic facet syndrome, posterior prosthesis for discal assistance, transitional osteosynthesis or foraminal stenosis.

The DIAM™ Device should not be implanted in patients who have an active infection, an allergy to silicone, polyethylene terephthalate or titanium, or who are pregnant.

How is the surgery performed ?

The DIAM device surgery is performed with the patient lying on his or her stomach. An incision a few centimeters long is made along the back of the spine. Then an instrument called a retractor is used to retract, or pull back, the muscle and tissue so that the surgeon can view the spine.  The surgeon will prepare the area for the implant by removing only the necessary interspinous ligament and potential bony overgrowth.

A series of templates are then used to select the appropriate-sized DIAM device, and the surgeon will implant the device between two spinous processes (the portion of the vertebrae that protrudes from the back of the spinal column, whic create the “bumps” that you can feel along the middle of the back.)  Two laces, or tethers, allow the surgeon to fasten the DIAM device to the adjacent vertebrae to stabilize it. The operation is completed when the surgeon closes the incision.

What can I expect after surgery?

Recovering from back pain and surgery is an ongoing process. How fast you recover depends on the type of surgery you had, your commitment to working closely with your physical therapist, and moving and exercising correctly, as recommended by your surgeon.

In most cases, immediately after surgery, your heart and lung function will continue to be monitored, a drainage tube may have been left in your wound and your doctor may prescribe medicines to control pain and nausea.  A nurse will show you how to care for your wound before you are sent home and your doctor will discuss a program to gradually increase your activity. You may be required to wear a back brace after surgery and you may be told to avoid repetitive bending, lifting, twisting and athletic activities while you recover. You may also be cautioned to avoid vibrations, such as those you might experience when driving a car, for a period of time after your surgery.

Contact your doctor immediately if:

  • you get a fever
  • the wound starts leaking fluids
  • you have trouble swallowing or breathing
  • you have trouble urinating
  • you have new or increased back or leg pain or numbness

After surgery, your surgeon may refer you to a physical therapist who will teach you exercises to improve your strength and increase your mobility. The goal of physical therapy is to help you become active as soon as possible, using safe body movements that protect your spine. This often includes abdominal strengthening exercises. You may also be taught different ways of standing, sitting, or lifting to avoid re-injuring your spine.

What possible complications could occur?

Potential risks to any surgical procedure include unforeseeable complications caused by anesthesia, blood clots, undiagnosed medical problems, such as silent heart disease, and rare allergic reactions. Some risks of spinal surgery include incomplete pain relief, damage to the nerve roots, infection, and complications with the hardware. Most of these complications can be treated once they are detected, but sometimes they require a longer period of hospitalization or recovery, additional medications, and sometimes even additional surgery.

In general, these complications happen very infrequently.

Return to treatments and operations.


The DIAM implant

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