Acta Ortopédica Mexicana

Alpízar-Aguirre A, Guevara-Álvarez A, Rosales-Olivares LM, Zárate-Kalfópulos B, Sánchez-Bringas G, Reyes-Sánchez A
Dynamic interspinous stabilization versus transpedicular fixation and arthrodesis in the treatment of lumbar stenosis in patients 45-65 years of age
Acta Ortop Mex 2012; 26 (6)

Language: Español
References: 45
Page: 347-353
PDF: 87.91 Kb.

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Introduction: Ligamentoplasty is a posterior dynamic stabilization method. The purpose of this study is to compare the incidence of adjacent segment disease in patients undergoing decompression and ligamentoplasty versus patients with standard 360° arthrodesis. Material and methods: Two groups were studied, each with 15 patients. The first group underwent recalibration with fixation (Group A) and the second group recalibration with ligamentoplasty (Group L). The occurrence of adjacent segment degeneration was assessed, together with the presence of adjacent segment disease in both groups. The statistical analysis was performed with the SPSS 17.0 software. Results: Both techniques showed a statistically significant clinical improvement at the six-month postoperative follow-up (p = 0.001). Radiographic findings showed a higher translational instability index at the one-year follow-up in the arthrodesis group. No statistical difference was found in the clinical course or in the rest of the radiographic variables at the 3-year comparison between both groups. The rate of adjacent segment degeneration in Group A was 33.3%, compared with 20% in Group L at the one-year follow-up. Until now, there have been two cases of radiculopathy, one in Group L and one in Group A, both with adjacent segment disease. Conclusion: At the 3-year follow-up it is not possible to say that ligamentoplasty, unlike 360° arthrodesis, decreases the rate of adjacent segment disease. However, this technique has promising results.

Key words: narrow lumbar canal, plasty, dynamic stabilization, arthrodesis, ligament, spine, fixation.