Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 24138
POSTERIOR DYNAMIC STABILIZATION USING THE DIAM (DEVICE FOR
INTERVERTEBRAL ASSISTED MOTION)
Mrinal SHARMA, Harsh BHARGAVA
Indraprasth Apollo Hospital, New Delhi (INDIA)
Introduction: Dynamic stabilization has proven to be useful in the management of
degenerative conditions of lumbar spine. The DIAM is a polyester-encased silicone
interspinous dynamic stabilization device that can unload the anterior column and
reestablish the functional integrity of the posterior column. The DIAM is thought to
work by reducing loading of the disc, restoring the posterior tension band, realigning
the facet joint line, and increasing foraminal height.Indications are facetal apopathy
with lumbago, unstable motion segment, canal stenosis, kissing spine syndrome and
spondylolysis.58 DIAM was implanted in 54 patients, 42 males and 14 females
(double implants in four) between sept 2006-oct 2009. There were no implant
migrations, or neurological injuries. Late infection was seen in 2 patients.There was
intraoperative breakage of supraspinatus ligament in two cases, so procedure
abandoned. A retrospective evaluation was performed based on patient
questionnaire at a median follow-up interval of 16 months. The pain level showed
improvement in 84%, no change in 8%, aggravation in 0%, and was indeterminate in
8%. The questionnaire revealed that at 16 months postoperatively, analgesic usage
was decreased in 70%, increased in 8%, and unchanged in 22% patients, and
activities of daily living were improved in >60%, decreased in 12%, and unchanged in
28%. Conclusion: If 80’s was the decade of pedicle screws. The 90’s was the decade
of interbody fusion devices. The new millennium is the era of non-fusion dynamic
stabilization procedures and devices. DIAM is a “Diamond” if used judiciously
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