This procedure is utilised to treat the effects of degenerative disc disease and spinal stenosis which may cause lower back pain and leg pain. The DIAM is a H shaped polyester covered, silicone implant, it is placed between 2 interspinous processes to restore the natural height of the disc. The DIAM takes the pressure off the disc and allows the nerves to exit freely in order to relieve pain. The DIAM is sutured in place with a mesh band to hold it in position.
Your Hospital Stay
On average patients will spend 2 nights in hospital. Post surgery after recovery you will return to the ward. You may need to lie flat for 3-4 hours post procedure. After this time you will be able to sit up in bed and encouraged to take deep breaths. You will be able to lie on your side if that is more comfortable. You will not be able to lie on your stomach yet.
On return to the ward if awake and alert you will be encouraged to drink plenty of fluids. If you feel able to you can mobilise with the assistance of a physiotherapist or nurse. If you have returned late to the ward the staff will mobilise you in the morning when you are more awake. You will be advised to mobilise gently initially and increase the frequency and length of time spent walking.
Each day post surgery you should try and undertake more tasks independently, i.e. washing and dressing.
On discharge you will be given approximately 1-2 weeks of analgesia and any other required medications. It is advisable that you continue taking your analgesia for at least 2 weeks post discharge. With most analgesia it is advisable to take a regular laxative as all analgesia has a constipating side effect. If you require further medications your GP should be able to write a prescription or your consultant in your follow up appointment will be able to prescribe further medication.
Prior to discharge you need to be as independent as you were pre surgery, if not better. You will be assessed to ensure you are safe to go up and down the stairs safely. Occasionally your surgeon may require that you wear a corset post surgery. This is to be worn when mobilising and sitting, not lying. When sitting a high backed arm chair is preferential to a low sofa. Initially sitting may be uncomfortable, build up how often and for how long you are sitting over the following few weeks. So by 4 weeks post surgery you can sit comfortably for 45mins-1hr at a time.
Driving: This is at your surgeons’ discretion. In general 2-3 weeks is most common practise to abstain from driving. You must be able to perform an emergency stop safely, without harming yourself or anyone else. You are able to be a passenger in a car post discharge. It is advisable to sit in the passenger seat, recline the seat back and place a cushion behind your back if more comfortable. If the journey is greater than 45 minutes have a break, stretch your legs at regular intervals.
Flying: This should be discussed with your surgeon as it may vary. 2-3 weeks is the recommended time to abstain. When flying it is advisable to recline your seat and regularly walk up and down the gangway.
Your consultant will advise you on this. If possible you will benefit from 4 weeks off work. If mainly sedentary you should take regular breaks from your desk. If you have a more active or physically demanding job you may require a longer period off work and lighter duties on return to work. If possible graduate your return to work, a few hours a day for a few days a week. If it is necessary to utilise public transport, travel at quiet times, early morning or late morning to avoid congestion.
The physiotherapist will advise you on any exercises during your hospital stay. Walking is the most beneficial exercise for you initially, this can be increased daily. During your follow up your consultant will advise you as to whether you can increase your levels of activity. Once your wound has fully healed, you will be able to partake in gentle exercise including swimming.
Do not lift anything over 3Kg in weight. No bending and no twisting until advised otherwise. No housework.
Your wound will have been closed with either clips or steristrips (paper strips) these are removed 10-14 days post operatively. You will be advised pre discharge of how to care for your wound. Ideally the dressing should be changed every 3 days. You will be given waterproof dressings on discharge. You may shower but not bathe yet.
If you have clips in situ these will need to be removed by your practice nurse or alternative arrangements made if you do not have a practice nurse. If you have steristrips in situ you can remove these yourself in the shower if you are able to 10 days post surgery. Or get a sensible family member to remove them. Once the clips or steristrips have been removed the wound can be left uncovered and it is okay to get the wound wet.
All information given is a guideline and may vary from person to person