DIAM Device for Low Back Pain in Degenerative Disc Disease

Buric, Josip; Pulidori, Massimiliano; Sinan, Tariq; Mehraj, Sheikh

doi:10.1007/978-3-211-99370-5_26

Cited by 13 publications

(12 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most previous studies focused on the hypermobility at the adjacent segments of topping-off technique. Buric et al [17] investigated the effect of long rigid fixation on adjacent levels with and without a transitional posterior dynamic stabilization at the caudal end. eir results showed an increased motion in the distal adjacent levels in all loading modes.…”

Section: Introductionmentioning

confidence: 99%

Topping-Off Technology versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation: A Meta-Analysis

Wang

Sun

Zhang

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

The treatment effects of topping-off technique were still controversial. This study compared all available data on postoperative clinical and radiographic outcomes of topping-off technique and posterior lumbar interbody fusion (PLIF). PubMed, EMBASE, and Cochrane were systematically reviewed. Variations included radiographical adjacent segment disease (RASD), clinical adjacent segment disease (CASD), global lumbar lordosis (GLL), visual analogue scale (VAS) of back (VAS-B) and leg (VAS-L), Oswestry disability index (ODI), Japanese Orthopaedic Association (JOA) score, duration of surgery, estimated blood loss (EBL), reoperation rates, and complication rates. Sixteen studies, including 1372 cases, were selected for the analysis. Rates of proximal RASD (P=0.0004), distal RASD (P=0.03), postoperative VAS-B (P=0.0001), postoperative VAS-L (P=0.02), EBL (P=0.007), and duration of surgery (P=0.02) were significantly lower in topping-off group than those in PLIF group. Postoperative ODI after 3 years (P=0.04) in the topping-off group was significantly less than that in the PLIF group. There was no significant difference in the rates of CASD (P=0.06), postoperative GLL (P=0.14), postoperative ODI within 3 years (P=0.24), and postoperative JOA (P=0.70) and in reoperation rates (P=0.32) and complication rates (P=0.27) between topping-off group and PLIF. The results confirmed that topping-off technique could effectively prevent ASDs after lumbar internal fixation. However, this effect is effective in preventing RASD. Topping-off technique is more effective in improving the subjective feelings of patients rather than objective motor functions compared with PLIF. With the development of surgical techniques, both topping-off technique and PLIF are safe.

show abstract

Section: Introductionmentioning

confidence: 99%

Topping-Off Technology versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation: A Meta-Analysis

Wang

Sun

Zhang

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Similarly, DIAM has shown promising results for back pain due to disc degeneration with improved pain in 78.9% of the cases for up to 4 years [ 35 36 37 38 ]. The first prospective controlled study comparing decompression with Coflex to decompression alone suggested that results in both groups are similar [ 39 40 ].…”

Section: Surgical Options For Back Painmentioning

confidence: 99%

Low Back Pain: Current Surgical Approaches

2015

View full text Add to dashboard Cite

Low back pain (LBP) is a worldwide phenomenon. The UK studies place LBP as the largest single cause of absence from work; up to 80% of the population will experience LBP at least once in their lifetime. Most individuals do not seek medical care and are not disabled by their pain once it is managed by nonoperative measures. However, around 10% of patients go on to develop chronic pain. This review outlines the basics of the traditional approach to spinal surgery for chronic LBP secondary to osteoarthritis of the lumbar spine as well as explains the novel concepts and terminology of back pain surgery. Traditionally, the stepwise approach to surgery starts with local anaesthetic and steroid injection followed by spinal fusion. Fusion aims to alleviate pain by preventing movement between affected spinal segments; this commonly involves open surgery, which requires large soft tissue dissection and there is a possibility of blood loss and prolonged recovery time. Established minimally invasive spine surgery techniques (MISS) aim to reduce all of these complications and they include laparoscopic anterior lumbar interbody fusion and MISS posterior instrumentation with pedicle screws and rods. Newer MISS techniques include extreme lateral interbody fusion and axial interbody fusion. The main problem of fusion is the disruption of the biomechanics of the rest of the spine; leading to adjacent level disease. Theoretically, this can be prevented by performing motion-preserving surgeries such as total disc replacement, facet arthroplasty, and non fusion stabilisation. We outline the basic concepts of the procedures mentioned above as well as explore some of the novel surgical therapies available for chronic LBP.

show abstract

“…16 After a follow-up period of 1-4 years, many papers have reported the biomechanical, radiological, or clinical outcome following implantation of DIAM spacers for the treatment of lumbar degenerative disc disease. 2,14,15 The majority of authors do not deny their positive influence on pain reduction, better mobility, and increased work capacity. Complications have been reported in 1%-10% of patients who have undergone implantation of DIAM spacers, and so far 2 kinds of complications have been distinguished: early, which are evident at the moment of discharge from hospital or 30 days after being discharged (dislocation/malposition, spinous process fracture, spinous process erosion, deep tissue infections, hematoma, or persistence of neurological sequelae), and delayed, noticed 1 month after surgery or later (recurrent spinal stenosis, recurrent disc herniation, postlaminectomy spondylolisthesis, and delayed deep wound infection).…”

mentioning

confidence: 91%

Aseptic intrafascial and extrafascial abscesses 10 years after a 2-level DIAM insertion procedure

Stefanovic¹,

Radisavljević²,

Stojanov

2015

SPI

View full text Add to dashboard Cite

With the aim to prevent the so-called adjacent-segment disease in spinal fusion surgery and to serve as the primary surgical procedure for the management of low-back pain syndrome or neurogenic claudication in spinal stenosis, the so-called dynamic spine stabilization is applied using specifically designed implants: interspinous spacers, such as DIAM (Device for Intervertebral Assisted Motion), Coflex, and X-stop. It is commonly accepted that interspinous spacers are made from material that is well tolerated by the body, that their placement is simple, that complications are rare, and that they can greatly benefit the patients. So far, there have not been published studies reporting infective or other complications 10 or more years after the placement of DIAM spacers. The aim of this paper was to present a case of an extremely late complication (after 10 years) in the form of intra- and extrafascial dumbbell abscesses, concomitantly appearing at both levels treated with the DIAM spacer. The paper presents the existence of a significant correlation between CT and MRI findings as well as the deterioration in Oswestry Disability Index and visual analog scale scores. Over time, dynamic spine stabilization might possibly impact reactive accumulation of sterile fluid in the vicinity of an implant and could therefore be related to delayed complications even 10 years after surgery. The finding of a growing layer composed of thick aseptic fluid around the DIAM implant, with a simultaneous occurrence of spinous process osteolysis and formation of a mineralized pseudocyst, bears a considerable risk of delayed inflammatory complications, including abscess, and therefore requires the explantation of the DIAM implant.

show abstract

DIAM Device for Low Back Pain in Degenerative Disc Disease

Cited by 13 publications

References 20 publications

Topping-Off Technology versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation: A Meta-Analysis

Topping-Off Technology versus Posterior Lumbar Interbody Fusion in the Treatment of Lumbar Disc Herniation: A Meta-Analysis

Low Back Pain: Current Surgical Approaches

Aseptic intrafascial and extrafascial abscesses 10 years after a 2-level DIAM insertion procedure

Contact Info

Product

Resources

About