medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2016, Number 4

<< Back Next >>

Acta Ortop Mex 2016; 30 (4)

Clinical course of decompressive surgery for the treatment of lumbar stenosis

Cano-Rodríguez AI, González-Moga A

Language: Spanish
References: 20
Page: 185-190
PDF size: 194.61 Kb.


ABSTRACT

Background: Several authors and publications have focused on comparing the clinical course of nerve root decompressive surgery, with or without fusion, to treat degenerative lumbar stenosis. However, there are not many reports analyzing the clinical course after decompressive surgery of a single nerve root (the most symptomatic one) comparing it with decompression of all the roots in a segment. This study intends to compare the clinical course after decompressing the most symptomatic lumbar nerve root with the release of multiple lumbar nerve roots to relieve neuropathic pain resulting from degenerative lumbar stenosis. Material and methods: A prospective, observational, descriptive longitudinal study was performed. A total of 38 patients were divided into two groups that included each 19 cases. Patients underwent recalibration of either a single nerve root or multiple nerve roots of a segment. Percentages were calculated as well as the Student t test and the Pearson correlation. Results: In group A, a decrease of 46.63 points was seen in the Oswestry scale, representing a 66.73% improvement in pain. In group B, in turn, a mean decrease of 34.54 points was seen in the Oswestry scale, equivalent to a 47.23% improvement in pain, with a Student t in which p = 0.11 and a Pearson correlation coefficient of 0.08. Conclusions: No statistically significant differences were found between both study groups.


REFERENCES

  1. Torrealba G. Patología de columna lumbar.

  2. Barrera-García M: Tratamiento de espondiloartrosis y canal lumbar estrecho. Ortho-tips. 2005; 1(2): 103-108.

  3. Brunori A, Bruni P, Mascioli G, Chiapetta F: Severe lumbar stenosis caused by chronic spinal epidural hematoma and multiple disk disease —case report and review of the literature. Zentralbl Neurochir. 1994; 55(3): 166-71.

  4. Hurt RW, Shaw MD, Russell JA: Spinal subdural haematoma: an unusual complication of lumbar puncture. Surg Neurol. 1977; 8(4): 296-7.

  5. Lunardi P, Mastronardi L, Lo Bianco F, Schettini G, Puzzilli F: Chronic spontaneous spinal epidural hematoma simulating a lumbar stenosis. Eur Spine J. 1995; 4(1): 64-6.

  6. Nehls DG, Shetter AG, Hodak JA, Waggener JD: Chronic spinal epidural hematoma presenting as lumbar stenosis: clinical, myelographic, and computed tomographic features. A case report. Neurosurgery. 1984; 14(2): 230-3.

  7. Miramontes-Martínez V. Tratamiento quirúrgico del conducto lumbar estrecho. Rev Mex Ortop Traum. 2002; 16(2): 70-5.

  8. Mota-Bolfeta R: Reflexiones sobre espondiloartrosis, canal lumbar estrecho degenerativo y vejez. Ortho-tips. 2005; 1(2): 72-6.

  9. Siebert E, Pruss H, Klingebiel R, Failli V, Einhaupl KM, Schwab JM: Lumbar spinal stenosis: syndrome, diagnostics and treatment. Nat Rev Neurol. 2009; 5(7): 392-403.

  10. Deyo RA: Back surgery —who needs it? N Engl J Med. 2007; 356(22): 2239-43.

  11. Kirkaldy-Willis WH, Wedge JH, Yong’Hing K, Reilly J: Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine (Phila Pa 1976). 1978; 4: 319-28.

  12. Ochoa-Carrillo H, Abad-Miranda L, Carrillo-Mora R: Recalibraje simple o con artrodesis en el canal lumbar estrecho degenerativo. Ortho-tips. 2005; 1(2): 111-119.

  13. Zucherman JF, Hsu KY, Hartjen CA, Mehalic TF, Implicito DA, Martin MJ, et al: A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results. Spine (Phila Pa 1976). 2005; 30(12): 1351-8.

  14. Cantarero-Moreira C: Eficacia de la discectomía lumbar para el alivio del dolor neuropático secundario a hernia discal lumbar. Servicio Nacional de Neurocirugía, Healf 2006. Nicaragua. 2007, 291-240.

  15. Gelalis ID, Stafilas KS, Korompilias AV, Zacharis KC, Beris AE, Xenakis TA: Decompressive surgery for degenerative lumbar spinal stenosis: long-term results. Int Orthop. 2006; 30(1): 59-63.

  16. Lehmann TR, Spratt KF, Tozzi JE, Weinstein JN, Reinarz SJ, el-Khoury GY, et al: Long term follow up of lower fusion patients. Spine (Phila Pa 1976). 1987; 12(2): 97-104.

  17. Lenoir T, Dauzac C, Rillardon L, Guigui P: Long-term survival analysis after surgical management for degenerative lumbar stenosis. Rev Chir Orthop Reparatrice Appar Mot. 2008; 94 (5): 464-71.

  18. Putzier M, Schneider SV, Funk JF, Tohtz SW, Perka C: The surgical treatment of the lumbar disc prolapse nucleotomy with additional transpedicular dynamic stabilization versus nucleotomy alone. Spine (Phila Pa 1976). 2005; 30(5): 109-114.

  19. Nickel R, Eagle T, Eysel P, Rompe D, Zöllner J, Hoffmann SO: Health-related quality of life and somatization in patients with long-term low back pain. A prospective study with 109 patients. Spine (Phila Pa 1976). 2001; 26(20): 2271-7.

  20. Holm I, Friis A, Storheim K, Brox JI: Measuring self-reported functional status by postal questionnaires. Spine (Phila Pa 1976). 2003; 28(8): 828-33.




2020     |     www.medigraphic.com