Conflicting diagnosis & now recommending DIAM

[trkdoc714]

Katie,

Without trying to sell you on or against a surgeon or medical service, I'd like to offer some advice.

Both my wife and I have been mis and maldiagnosed. Had I listened to the first, second or thied surgeons, I'd have 4 vertibrae fused together today. My wife would be in a similar state.

Most surgeons are going to diagnose and prescribe procedures that they are comfortable with. If I were in your shoes I would make appointments with more specialists for more diagnosis. This is ultimately what we did although it wasn't planned that way. With several opinions rendered, you should be able to see a pattern and commonalities in the diagnosis. This helped Vanita and I choose what we both feel is our best option.

Good luck Katie,

Bob

[mmglobal]

Diam is one in a huge crop of interspineous devices that came out several years ago.

Fixano U, now Coflex; x-stop, wallis, and many more. Typically, they are motion limiting devices instead of motion perserving devices, but will allow more motion than fusion.

The new Disc-Motion posterior ADR with spinal stablization is in play for people who want motion preservation but not fusion. I'll be writing more about this later in the week as I've seen an implantation and have discussed it pretty extensively with Bertagnoli.

[johnb]

Advantage of the DIAM is that it less invasive compared to some other procedures and can be removed without too much invasiveness so other, possibly more aggressive (and probably more invasive) treatments being available on down the road. As far as facets go, mine were pain generators and were bone rubbing on bone and fused while I had the dynesys implant on my spine. In fact, they started to fuse in the first 3 months of having it implanted. (can I assume that my body will generate bone if I have a anterior fusion?) The DIAM should distract your facets so they aren't rubbing on each other all the time and open the lateral canals if there is stenosis there. The implant is sometimes combined with a decompression procedure. My facets deteriorated pretty fast once my disc height reduced. Also, my surgeon said my facets didn't look to bad on the MRI and yet they were painful. Point is, don't rely on MRI to determine if your facets are painful. The standard is diagnostic injections to test your facets. All the medical journals I've read say that the injections should be used to rule out ADR if your facets are painful. I've read anecdotal evidence of ADR helping facets by aligning things but I don't know of any double blind well designed clinical testing to support this possibility. I've seen posts of patients so there is some anecdotal evidence. However, I need science to back up claims when it comes to my health and spine. Anecdotal and case studies are not enough when it comes to my spine.

I've read most of these articles on facet joints on medspace which is a great resource. Medscape Search

The article on bone scan with SPECT was very informative Log In Problems