[Liz]

hi katie,

i don't know your full story, but my understanding is interspinous process spacers like the DIAM are designed primarily for patients with spinal stenosis (ie LEG pain/numbness); i think in theory they may also unload a degenerating disc but if i did not have leg issues i would be cautious about putting in 3 DIAMs. some surgeons will not even operate on patients without leg pain (or deformity). back pain is much harder to diagnose and it's not emergent the way leg pain/numbness can be in terms of permanent nerve damage. i don't think it's any less disabling though, as i suffered w/disc pain (w/leg issues) for yrs and now have facet joint pain.

anyway, if you don't have any leg issues now, please be aware that a 3 level lumbar procedure could result in nerve damage and you may end up with leg issues.... this is not meant to scare you, just reality.

150 procedures is a lot for the DIAM i think... your surgeon is experienced. perhaps you could ask to talk w/a few of his patients w/"similar" pain as yours pre-op (ie only back pain) and see how they are doing. Is your main pain coming from your discs or facet joints?

i would try and get a 3rd opinion since your two opinions are so varied. does the surgeon recommending DIAM perform ADR? perhaps you could have a combo of DIAM and ADR or fusion? ADR is anterior (now) and DIAM is posterior so you could get one or the other on one level first and the other op later. so many new minimally invasive therapies are in the works for disc pain. i would also consider fusion depending on the condition of your facet joints.

you're definitely not old, so i would also ask how "active" you could be with 3 DIAMs without risking device failure. i think they are deigned for older patients that want to walk, golf, other mellow sports, but no skiing!

hang in there and best of luck to you,
Liz