Device for intervertebral assisted motion

Insertion of an interspinous devices has became a common procedure for the treatment of different clinical picture of degenerative spinal disease. We present our experience in 1,575 patients with the use of two different interspinous spacers: Device for Intervertebral Assisted Motion (DIAM) and Aperius PercLID system. From 2000 through 2008, 1,315 consecutive patients underwent DIAM implantation and 260 had an Aperius PercLID procedure. The main surgical indications included: degenerative disc disease (478 patients), canal and/or foraminal stenosis (347 patients), disc herniation (283 patients), black disc and facet syndrome (143) and topping-off (64 patients)...

Patients with low back pain (LBP) suffer chronic disability. In 40% of LBP patients degenerative disc disease (DDD) seems to be the cause. This prospective case series assessed the efficacy of the interspinous device for intervertebral assisted motion (DIAM™) in patients with LBP resulting from DDD. All patients were initially assessed by physical examinations, magnetic resonance imaging, dynamic X-rays and provocative discography. Eligible patients (n = 52) had LBP for a minimum of 4 months, and received surgery with the DIAM™ system 2-4 weeks after diagnosis...

BACKGROUND: The Dynamic Interspinous Assisted Motion (DIAM) system was designed to stabilize degenerative spinal segments without fusion surgery, maintain segment motion and prevent adjacent segment degeneration. The aim of this study was to investigate clinical efficacy of the DIAM system in treatment of degenerative lumbar disease in China. METHODS: Eight cases of lumbar vertebral instability were treated with the DIAM system at Peking Union Medical College Hospital from June 2006 to January 2008...

Recently, the Device for Intervertebral Assisted Motion (DIAM™) has been introduced for surgery of degenerative lumbar disc diseases. The authors performed the current study to determine the survivorship of DIAM™ implantation for degenerative lumbar disc diseases and risk factors for reoperation. One hundred and fifty consecutive patients underwent laminectomy or discectomy with DIAM™ implantation for primary lumbar spinal stenosis or disc herniation. The characteristics of the 150 patients included the following: 84 males and 66 females; mean age at the time of surgery, 46...

STUDY DESIGN: Prospective, randomized trial. OBJECTIVE: To assess the in vivo kinematics of the cervical spine after cervical fusion and arthroplasty. SUMMARY OF BACKGROUND DATA: Compared with spinal fusion, disc replacement may impede the development of adjacent segment disease. To achieve this goal, any arthroplasty device should achieve desired spinal alignment while maintaining physiologic spinal motion at both the operated and surrounding motion segments...

OBJECTIVE: This study assessed the safety and efficacy of one level unilateral laminotomy bilateral decompression (ULBD) with the placement of a device for intervertebral assisted motion (DIAM) compared with one level ULBD only in elderly patients with degenerative lumbar spinal stenosis (DLSS). METHODS: A non randomized prospective analysis was performed on 16 patients who underwent one level ULBD with DIAM (Group A) and 20 patients with one level ULBD only (Group B) between February 2007 and March 2008...

The DIAM (Device for Interspinous Assisted Motion) interspinous device offers the possibility of a viscoelastic supplementation of the lumbar motion segment with a small, reversible operation. It is intended as a restabilisation procedure after a discectomy to avoid facet joint overload and as a topping of procedure for the segment adjacent to a fusion. The device has been on the German market since 2004. There are several biomechanical studies available showing an effect mainly in extension and flexion, but hardly any in rotation and lateral inclination...

OBJECTIVE: To elucidate the new development, structural features and application of the lumbar inter-spinous process non-fusion techniques. METHODS: With the review of the development course and important research works in the field of the lumbar inter-spinous process non-fusion techniques, the regularity summary, science induction, and prospect were carried out. RESULTS: The lumbar inter-spinous process non-fusion technique was a part of non-fusion insert of spinal division posterior surface...

STUDY DESIGN: Kinematic study of a single site in an investigational device exemption trial. OBJECTIVE: Evaluate the center of rotation (COR) after Bryan cervical arthroplasty and compare adjacent segment motion after cervical disk arthroplasty and fusion using validated radiographic analysis. SUMMARY OF BACKGROUND DATA: The goal of cervical arthroplasty is to reestablish spinal kinematics after anterior decompression. Excellent maintenance of range of motion has been reported for a variety of the prostheses; however, the manner the prostheses perform this task is different...

STUDY DESIGN: A validated nonlinear three-dimensional finite element model of a single lumbar motion segment (L3-L4) was used to evaluate a range of moduli for ideally conforming nucleus replacement devices. OBJECTIVE: The objective of the current study was to determine the biomechanical effects of nucleus replacement technology for a variety of implant moduli. We hypothesized that there would be an optimal modulus for a nucleus replacement that would provide loading in the surrounding bone and anulus similar to the intact state...

STUDY DESIGN: Radiographic results of a multicenter, prospective randomized study comparing 1-level cervical total disc replacement (TDR-C) with anterior cervical discectomy and fusion (ACDF). OBJECTIVE: To evaluate the effect on device-level lordosis, cranial and caudal adjacent level lordosis, and overall cervical sagittal alignment (C2-C6) after TDR-C or ACDF. SUMMARY OF BACKGROUND DATA: Cervical total disc replacement (TDR-C) has emerged as a promising alternative to ACDF in a select group of patients...

STUDY DESIGN: Segmental motion and bone-implant interface stresses were analyzed at C5-C6 levels with Bryan, Prestige LP, and ProDisc-C cervical disc prostheses using an image-based finite element modeling technique. OBJECTIVE: To predict stress patterns at the interface between prosthesis and lower vertebral end plate to better understand the underlying mechanisms of subsidence and how the load transfer pattern of each disc design affects segmental motion. SUMMARY OF BACKGROUND DATA: Subsidence is one of the most commonly reported device-related complications in intervertebral disc arthroplasty...

BACKGROUND: Motion restoring implants function in a dynamic environment that encompasses the full range of spinal kinematics. Accurate assessment of the in situ performance of these devices using numerical techniques requires model verification and validation against the well-established nonlinear quality of motion of the spine, as opposed to the previous norm of matching kinematic endpoint metrics such as range of motion and intervertebral disc pressure measurements at a single kinematic reference point...

Target of the study was to predict the biomechanics of the instrumented and adjacent levels due to the insertion of the DIAM spinal stabilization system (Medtronic Ltd). For this purpose, a 3-dimensional finite element model of the intact L3/S1 segment was developed and subjected to different loading conditions (flexion, extension, lateral bending, axial rotation). The model was then instrumented at the L4/L5 level and the same loading conditions were reapplied. Within the assumptions of our model, the simulation results suggested that the implant caused a reduction in range of motion of the instrumented level by 17% in flexion and by 43% in extension, whereas at the adjacent levels, no significant changes were predicted...

Different interspinous implants are used as minimal invasive intervention in the management of degenerative disorders of the lumbar spine. We present a case with foreign body reaction due to polyethylene's wear after a device for intervertebral assisted motion (DIAM) implantation. We conclude that the polyethylene interspinous devices can cause biological response, therefore; the surgeons and the companies should carefully watch their patients following application of such devices.

OBJECT: 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. METHODS: The DIAM was implanted in 104 patients between May 1, 2001 and October 30, 2001. A retrospective evaluation was performed based on chart review and patient questionnaire at a median follow-up interval of 18.1 months. There were no implant migrations, infections, or neurological injuries...

BACKGROUND CONTEXT: Lumbar fusion has been associated with inconsistent clinical outcomes and significant complications. Posterior dynamic devices have been developed to stabilize painful diseased lumbar motion segments while avoiding fusion. The Device for Intervertebral Assisted Motion (DIAM) is a silicone interspinous process "bumper" that is being clinically implanted for varied indications. PURPOSE: We analyzed the effects of the DIAM device on the biomechanical response of the lumbar spine in flexion-extension, lateral bending, and axial rotation after partial facetectomy and discectomy; the clinical situations in which its use might be considered...

This in vivo biomechanical study was undertaken to analyze the consequences for sagittal balance and lumbar spine movement in three different lumbar disc prostheses. A total of 105 patients underwent total disc replacement in three different centers. The Maverick prosthesis was used in 46 patients, the SB Charité device was used in 49 patients and the Prodisc device was utilized in 10 patients. The analysis was computer assisted, using Spineview and Matlab softwares. The intra and inter-observer reliability and measurement uncertainty was performed...

This study compared the accuracy of new, FDA-approved, image-analysis software to conventional radiographic assessment techniques for the measurement of intervertebral motion. Six adult human cadaveric lumbar spines (L1-S1) were individually mounted in a custom Plexiglas device and electromagnetic sensors were rigidly mounted to the spinous processes of L3, L4, and L5. Lateral radiographs of the spines in neutral, full flexion, and full extension were digitized and analyzed both using the software and manually by three orthopedic surgeons...

Degenerative disc disease is the leading cause of pain and disability in adults in North America, and spinal fusion is the standard treatment. Despite this, it has been discussed among surgeons that (1) spinal fusion deserves reexamination in terms of its long-term consequences and benefits and (2) modern clinical research and development in disc arthroplasty strongly supports its emergence as an alternative. The ability to relieve pain by maintaining motion may be a critical factor in obtaining not only greater pain relief but in preventing adjacent segment degeneration...