The DIAM System. The DIAM Spinal Stabilization System (Medtronic Sofamor Danek) is a soft interspinous spacer (Fig. 4). The core is made of silicone, which is covered by a polyethylene coating. The surgical technique consists of identifying the interspinous space, removing the remnants of the interspinous ligament down to the ligamentum flavum, and using a distracter of the spinous processes to facilitate the insertion of the device. It is secured in place with two laces, one around the spinous process above, and another around the one below.