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Revista Cubana de Ortopedia y Traumatología
versión impresa ISSN 0864-215X
Resumen
TABARES NEYRA, Horacio Inocencio; DIAZ QUESADA, Juan Miguel; TABARES SAEZ, Horacio y TABARES SAEZ, Laura. Surgical treatment of degenerative lumbar stenosis in elderly patients based on imaging findings. Rev Cubana Ortop Traumatol [online]. 2013, vol.27, n.2, pp.157-172. ISSN 0864-215X.
Introduction: degenerative lumbar stenosis in elderly patients is a serious health problem. Objective: demonstrate the validity of the surgical treatment of degenerative lumbar stenosis in elderly patients when decision on what technique to apply is based on X-ray and magnetic resonance imaging findings. Methods: a study was conducted of 102 patients aged over 65 cared for at the Center for Research on Longevity, Aging and Health from 1 January 2002 to 31 December 2008. The variables considered were age, sex, location, main comorbid conditions, and classification based on X-ray and magnetic resonance imaging. Decision on the surgical technique to apply was based on imaging findings. The Oswestry index and the Pain Visual Analog Scale were used as evaluation instruments. The surgical techniques applied were simple release, recalibration and laminectomy, instrumentation and fusion. Results: there was a predominance of male patients in the 65-70 age group with location at two vertebral levels and cardiovascular comorbid conditions. The largest number of cases were classed as degrees 3 and 4 on Kellgren's scale, and IV and V on Pfirrmann's. The Oswestry index and the Pain Visual Analog Scale showed significant improvement at two years, and 88 % of the results obtained were good. Conclusions: determination of the surgical technique to apply based on imaging findings makes it possible to obtain good results in a high percentage of the patients undergoing surgery. There is an appropriate relationship between imaging findings and surgical technique.
Palabras clave : degenerative lumbar stenosis; imaging; surgery.