[Mechanical consequences of the surgical treatment of lumbar stenosis].
In a series of 84 cases of lumbar stenosis duly controlled with lateral X-rays at each visit, 7 post-operative slips were discovered (8 p. cent). They occur very early, are moderate and do not seem to become worse. The functional repercussion was actually present on only 2 instances. 5 occurred spontaneously, 2 represented the aggravation of an arthritic spondylolisthesis. The preferred localization is L4-L5 and the slip seems to develop especially on pinched but still thick discs, and spines with an over-lordosis. Multi-levels total lamino-arthrectomy promotes slipping but this wide resection is not an exclusive factor. The knowledge of anatomical factors of risk enables to limit the indication of a stabilizing arthrodesis and the low slipping risk versus the much higher percentage of failure because of insufficient resection, prompts the author to keep performing wide releases on demand.
de La Caffinière
J Y
JY
Service de Chirurgie Orthopédique et Traumatologie, Hôpital Delafontaine, Saint-Denis.
D001696:Biomechanical Phenomena; D006801:Humans; D007404:Intervertebral Disc Chemolysis; D007796:Laminectomy / Q000009:adverse effects; D008141:Lordosis / Q000209:etiology; D008159:Lumbar Vertebrae / Q000502:physiology* / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects; D013130:Spinal Stenosis / Q000601:surgery*; D013168:Spondylolisthesis / Q000150:complications
Conséquences mécaniques de la cure chirurgicale de la sténose lombaire.