An Investigation of Revisional Surgery After Implantation of Device for Intervertebral Motion (DIAM): A Case Series Study

Abstract

Background: The application of the Device for Intervertebral Assisted Motion (DIAM™) is a spinal fusion device recently and widely development for the treatment of lumbar degenerative diseases. Among the Interspinous Process Devices (IPDs) the Device for Intervertebral Assisted Motion (DIAM™) is a relatively newer fusion technology, based on the placement of a flexible IPD. Purpose: This study was aimed to evaluate the clinical outcome of a widely used IPDs called DIAM™. Methods:The patients (n=44) had undergone DIAM™ placement were evaluated the medical records in our hospital. The demographic data and diagnosis were recorded. Revision surgery was performed for each patient and follow-up was based on medical and radiological records.Results: Forty-four patients with a mean (±SD) age of 58.80(±13.12) years underwent the revision surgery of DIAM™. The complication of patients' previous revision surgery, arranging from low to high was in DIAM™ alone with infection (2 cases), DIAM™ alone with instability (3 cases), preventing Adjacent Segment Disease (ASD) (6 cases), inadequate decompression (30 cases), DIAM™-involved instability with stenosis (34 cases).Conclusions: DIAM™ may not be a comprehensive interspinous process decompression device to treat all kinds of spinal diseases due to its various postoperative complications. The predominant DIAM™ indications would be disc herniation, spinal stenosis, black disc disease, and fusion after ASD (topping Off).