[Recalibration via a postero-lateral approach in recent traumatic stenosis of the dorsal and lumbar spine. Modalities and results apropos of 31 cases].
The authors present 31 cases of spinal trauma affecting thoraco lumbar level with severe spinal canal stenosis secondary to compressive trauma of the anterior disco-corpereal region. Associated neurological disorders were of varying severity. 23 cases were investigated by computed tomography. In all cases, the surgical procedure involved rectification of spinal deformities, with initially a unilateral postero-lateral approach permitting anterior spinal canal recalibration, either by impaction of protrusive fragments or ablation of free disc fragments. The stabilization was usually achieved by complementary bilateral plates using Roy-Camille or Privat material in 22 cases, associated with postero-lateral arthrodesis by grafting with reconstruction of the articulo-pedicular structure in 19 cases. Emergency operation was done in 14 cases; in 5 cases operation was done on the 2nd or 3rd day and in 11 cases after the 3rd day. The functional spinal result was excellent, and recalibration was verified by tomography in all cases. In those cases showing neurological deficiency, good and early recovery was attributable to the suppression of spinal canal stenosis, and a consequently neurological improvement was always obtained, even for the most serious of lesions except those at the thoracis level superior to T10. The application of this postero-lateral approach for severe spinal trauma seems to represent, in all cases of recent lesions, an alternative to the anterior or combined methods. We do not share the opinion that delay in decompression does not influence the neurological prognosis and emergency operation is advisable.
Richaud
J
J
Département de Neurochirurgie, C.H.U. Rangueil, Toulouse.
Bousquet
P
P
Ealet
G
G
Clamens
J
J
Beltchika
K
K
Lazorthes
Y
Y
D000293:Adolescent; D000328:Adult; D004630:Emergencies; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D008159:Lumbar Vertebrae; D008297:Male; D010264:Paraplegia / Q000209:etiology; D013123:Spinal Fusion / Q000379:methods*; D013124:Spinal Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D013130:Spinal Stenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed
Recalibrage par voie postéro-latérale des sténoses traumatiques récentes du rachis dorsal et lombaire. Modalités et résultats à propos de 31 observations.