This procedure treats the effects of degenerative disc disease and spinal stenosis which may cause lower back pain and leg pain. The DIAM is an H shaped polyester covered, silicone implant, it is placed between two inter-spinous 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.

Hospital stay

On average patients will spend two nights in hospital. You may need to lie flat for 3-4 hours following the procedure. After this time, you will be able to sit up in bed and will be encouraged to take deep breaths. You will be able to lie on your side if that is more comfortable, however not on your stomach yet.

On return to the ward 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. You will be advised to mobilise gently initially and increase the frequency and length of time spent walking.

Each day post surgery you will be encouraged to undertake more activities for yourself such as washing and dressing.

Medication

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 two 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. Alternatively, your consultant will prescribe if appropriate at your follow-up appointment.

Mobility

In order to be discharged you need to be as independent as you were pre-surgery, if not more so.

Your surgeon may require that you wear a corset post surgery.

When sitting a high backed arm chair is preferential to a low chair or sofa. Initially you may find sitting uncomfortable and it is advisable to build up how often and for how long you are sitting over the following few weeks. You should aim 4 weeks post surgery to be able to sit comfortably for 45mins-1hr at a time.

Driving

Your surgeon will advise, however it is common to abstain from driving for 2-3 weeks. 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 surgery. It is advisable to sit in the passenger seat with the seat reclined and use a cushion for support if comfortable. If the journey is greater than 45mins have regular breaks and stretch your legs.

Flying

Your surgeon will advise, however it is common to abstain from flying for 2-3 weeks following surgery.

When flying it is advisable to recline your seat and regularly walk up and down the gangway.

Work

Your consultant will advise you on this, however 4 weeks of rest, away from work, is common. If possible graduate your return to work; a few hours a day for a few days a week. If absolutely necessary to take public transport travel at quiet times, early morning or late morning, avoiding rush hour. If you are in a sedentary job regularly stand and walk around. If you have an active job you may require a longer period off work and should consider lighter duties on your return.

Exercise

Your physiotherapist will advise you on any exercises to be done during your hospital stay. Walking is the most beneficial exercise for you initially and this can be increased daily. During your follow-up appointment 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 enjoy gentle swimming.

Do not lift anything over 3kg in weight. You must not bend or twist until advised otherwise.

Wound care

Your wound will have been closed with either clips or steristrips (paper strips) which will be removed 10-14 days post surgery. You will be advised pre-discharge of how to care for your wound. Ideally, the dressing should be changed every three days. You will have been given several spare waterproof dressings and may shower but not to bath. If you have clips in situ these will need to be removed by your practice nurse 10 days post surgery. Once the clips, or steristrips, have been removed the wound can be left uncovered and it is okay to get the wound wet.

Information given are guidelines and may vary from patient to patient.