Mr. D'Urso performs surgery to relieve back pain and
related problems. As part of the surgical procedure
to "normalise" or "stabilise" the
spine, Mr. D'Urso may use either the DIAM System or
Wallis Implant. These implants are the latest in spinal
surgery technology, and avoid the need for more invasive
spinal fusion procedures, thus allowing retention of
motion in the affected spine segment. See detailed information
here regarding both of these systems.
with the DIAM System
The DIAM Spinal Stabilisation System can be used with
minimally invasive surgical techniques, and provides
flexible support of the lumbar spine while treating
spinal degeneration. The "Device for Intervertebral
Assisted Motion" (DIAM) is a new technology from
Medtronic that treats back problems without the need
for spinal fusion.
The DIAM Spinal stabilisation system was designed to
aid in the treatment of degenerative disc disease. The
DIAM acts as a spacer which when placed between two
spinous process restores the natural height of the disc,
taking the pressure off the intervertebral disc and
associated structures, and allows the nerve to exit
freely from the spinal cord while maintaining normal
movement of the spine. The device is made of a hardened
silicone covered with a polyethylene sock and has two
ligatures, which allow it to be secured in place between
the two spinous processes.
What are the advantages of the
Following standard surgery where a part of the
intervertebral disc is removed (discectomy), the rest
of the disc can degenerate further potentially requiring
fusion surgery at a later date. In fusion surgery the
surgeon uses a bone graft to join, or fuse, two or more
vertebrae together. Once the bone and spinal bone grow
together, the two vertebrae function as one unit, stabilizing
that part of the spine. With the disc space restored
to its original height, pressure on nerves is usually
relieved. The DIAM spinal stabilization system negates
the need for fusion in some patients and can act as
an alternative for fusion in some patients. The device
is designed to assist in allowing normal motion in the
spine. In addition, the device may help to protect the
spine from mechanical stress that can cause further
degeneration of discs near the level of surgery.
Who can benefit from surgery?
You may benefit from the DIAM spinal stabilization
- Mr. D'Urso has confirmed by your history and xray
studies that you have degenerative disc disease in
your lower back;
- You have narrowing of a vertebral opening due to
loss of disc height; or
- You have back and/or leg pain that has not responded
to non-surgical treatment.
How is the surgery performed?
The DIAM spinal stabilisation system surgery takes only
a short time added onto the standard procedure of discectomy.
Mr. D'Urso will access your spine through an opening
in your back, remove portions of the degenerated disc,
measure the required height and then position the DIAM
to maintain function of your spine. There are alternative
treatments to this surgery, both surgical and non-surgical.
You should discuss these options with Mr. D'Urso before
making your decision.
What is the recovery process?
Immediately after surgery, you will be moved to the
recovery room where you will remain for a few hours
while your recovery from the anaesthesia is monitored.
After you awaken fully, you will be taken to your hospital
room. You may have a drainage tube in your wound and
Mr. D'Urso may prescribe medicines to control pain and
nausea. Ask Mr. D'Urso about your hospital stay and
your specific recovery plan following surgery. It is
important to follow your doctor's instructions carefully
to recover from surgery as quickly as possible and increase
your chances of a successful outcome. After surgery
Mr. D'Urso may refer you to a physical therapist that
will teach you exercises to improve your strength and
mobility. The goal of physical therapy is to help you
become active as soon as possible, using safe body movements
that protect your back. You and your surgeon will continue
to work together during your recovery. Before you leave
the hospital, Mr. D'Urso may schedule follow up visits
with you so he can evaluate your progress.
What are the possible complications?
As with any surgery, spinal surgery is not without
risk. Complications, such as infection, blood loss,
bowel or bladder problems, are some of the potential
adverse risks. Please consult Mr. D'Urso for a complete
list of indications, warnings, precautions, adverse
events, clinical results and other important medical
information, if necessary.
Click here for a
Patient Information Brochure on the DIAM System
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with the Wallis Implant
In the management of degenerative
disc disease, flexible stabilisation of the lumbar spine
is potentially a very attractive alternative to spinal
fusion, especially for younger patients. Disc replacement
is certainly another option but it requires major surgery.
In certain cases, the Wallis implant is considered to
be the best treatment for disc degeneration. This implant
is most commonly used in the treatment of intervertebral
disc herniation and for tears in the outer layer of
the disc. The initial flexible vertebral fixation concept
began in 1984 in order to restore the normal kinematics
of the diseased level. This design acts to normalise
the movement of the diseased disc which helps to reduce
pain and promote disc healing by reducing load and stress.
After 15 years experience the second generation implant
has been developed called the “Wallis Implant.” Contrary
to spinal screws, the Wallis implant will preserve the
mobility of the spine segment. It will also eliminate
any bone disruption, is totally reversible, and will
keep all other options of treatment open. The Wallis
implant was introduced into Australia in 2002 and has
received Therapeutic Goods Administration approval.
The Wallis is an interspinous implant dedicated to
lumbar degenerative instabilities such as:
- Herniated disc
- Modic 1 degenerative lesions
- Degenerative disc disease at a level adjacent to
a previous fusion
- Narrowing of the spinal canal treated without laminectomy
The Wallis non-fusion interspinous implant:
- Restores and preserves disc height
- Allows shock absorption and load sharing
- Preserves anatomy with minimal bone and ligament
The implant acts to treat the back pain while preserving
the mobility and anatomy of the treated segment. The
Wallis is completely reversible as compared to an instrumented
spinal fusion which demands significant bone removal
and is completely non reversible. Current figures indicate
1 in 4 spinal fusions require reoperation.
The interspinous placement of the implant allows restoration
of disc height and reduction of the load on the disc
and the facets. During movements of forward and backward
bending the disc loading conditions are reduced, which
leads to pain relief with preserved mobility.
Without doubt the Wallis is an effective, simple and
reversible alternative to a spinal fusion. For the right
candidate, the Wallis implant is an ideal way to treat
pain and return the spine to normal mechanical activity,
without the costs and complications of Spinal Fusion.
There have been over 300 Wallis procedures carried out
in Australia since its introduction with no documented
negative results, and the popularity of this excellent
implant is growing as more positive outcomes are established.
here to view a Wallis patient booklet
here to view the Wallis Procedure Patient Information
to view the Spinal Stabilisation Implant Overview
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