Abstract

SANTOS COTO, Carlos; RIVAS HERNANDEZ, Rafael  and  FLEITES MARRERO, Ernesto. Surgical treatment of lumbar canal stenosis. Rev Cubana Ortop Traumatol [online]. 2009, vol.23, n.2. ISSN 0864-215X.

INTRODUCTION: The treatment of degenerative lumbar stenosis is a controversial subject. Due to the failure of non-significant methods and to on request of patient to achieve a improvement, it is proposed the need of a surgical decompression.  The aim of present research was to demonstrate the effectiveness of surgical treatment in cases of lumbar canal stenosis in patients operated on by recalibration techniques, laminectomy, instrumentation and fusion from January to December, 2008. METHODS: A prospective and descriptive study was conducted on surgical treatment in rachidial lumbar canal stenosis in patients operated on in “Fructuoso Rodríguez” Orthopedics Hospital from January to December, 2008. The choice of the type of surgery was determined by the stenotic specific anatomic area of vertebral canal.  Significant variables were analyzed to define the feasibility to apply each surgical procedure. RESULTS: Cohort included 15 patients mean aged 49,6 and a male sex predominance. Laminectomy was carried out in 10 patients, a fusion in 5 and recalibration in 10. There was a marked improvement in patients presenting with neurogenic claudication, with a Oswestry’s rate of 62,7 decreasing to 22,1. In patients with lumbar back pain Oswestry’s rate decreased from 77,1 to 15,1. CONCLUSIONS: Techniques used for central stenosis included laminectomy with instrumentation and for lateral recess stenosis we used the recalibration technique described by Senegas. It is recommendable to perform chorion-ligamentoplasty which gives dynamic stability to recalibrated segment, limits the extension in that level, and decreases the overload and subluxation of articular superficies protecting the adjacent space.

Keywords : Lumbar canal stenosis; Senega;s recalibration; laminectomy and instrumentation.

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