Diam Implant for Spinal Stenosis

by LMatthews on November 4, 2010

Diam Implant Update

Diam Implant for Spinal Stenosis

Diam Implant for Spinal Stenosis

A fairly recent innovation in spinal surgery for degenerative disc diseases such as spinal stenosis is the use of the Device for Intervertebral Assisted Motion (DIAM™). This device, first introduced in Europe in 2003 by Medtronic Inc., is used in cases of disc herniation or spinal stenosis and is often implanted after a laminectomy, facetectomy, or discectomy. The DIAM is just one of a number of different interspinous spacers commonly used to treat lumbar spinal stenosis or facet joint arthritis. These devices aim to reduce the load on the facet joint, provide stability of the spine whilst maintaining motion, and to restore foraminal height that can be lost through degenerative disc disease, or spinal surgery. Other implants include Coflex, Wallis, and X-STOP. A study published earlier this month, by Sur, et al (2010), analyzed the long-term success rate when using the DIAM and reported some promising findings.



DIAM Study Findings

The researchers looked at 150 patients having the DIAM implanted after laminectomy or discectomy in conditions of spinal stenosis or disc herniation and showed only seven instances where patients had to have a further procedure within four years of surgery which could be attributed to the DIAM. Of these patients, three had further development of spinal stenosis, two had recurrent disc herniation, one a delayed deep wound infection, and one patient developed post-laminectomy spondylolisthesis. Sur (et al, 2010) predicted an 8% reoperation rate with the DIAM four years post-operatively, making the use of this device very likely to become common in spinal stenosis surgery . Some patients, however, seemed more at risk of complication than others, with the researchers highlighting those having the DIAM implantation at L5-6 and at two-levels in patients with lumbosacral transitional vertebra (LSTV).

A smaller study published in 2009 reported that patients who had the DIAM implantation had an average improvement on the Oswestry Disability Index (ODI) of 63.85% (Hrabálek). Patients also showed improvements in the incidence of pain of 70.75 %. The greatest improvements in terms of disability were found in patients who had recurrent disc herniation. None of the sixty-eight patients in this study had further disc herniation within the three year follow-up. Ryu, et al (2010), found similar benefits in terms of pain reduction with patients showing significantly decreased lower back pain when the DIAM was used with a unilateral laminotomy bilateral decompression (ULBD), compared to the ULBD on its own, in elderly patients. However, they did not find any clinically significant differences in respect of leg pain reduction, disc height, or sagittal alignment.

Clinical Trials

There are several clinical trials currently registered and recruiting which aim to further test the safety and efficacy of these interspinous spacers such as the DIAM. Current research appears to demonstrate their effectiveness at relieving day-to-day spinal stenosis symptoms, alongside a favorably low incidence of post-operative complication and re-operation.


References


{ 2 comments… read them below or add one }

Stephen hedley July 13, 2011 at 12:02 am

Hi, had diam implant 5 weeks ago. Previously could barely walk 100m without pain, now walking 4 miles per day without leg pain. Only issue so far is reduced flexibility and small pain twinges in lower back region. No back spasms since survey. Managed to
Owe 12 pounds in weight due to increase exercise post op

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Stephen Hedley November 5, 2014 at 5:38 am

Well 3 years on an no spasms, have about 95% normal life. Learnt to swim in 2013 and now swimming 1 mile per day in 30 mins. Avoiding running and lifting. Also gardening out.

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