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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2025, Number 1

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Cir Columna 2025; 3 (1)

Management for the patients with degenerative lumbar spinal stenosis. Our experience in a Third Level Hospital

Infante LCG, Gervacio GHC

Language: Spanish
References: 21
Page: 31-36
PDF size: 210.50 Kb.


ABSTRACT

Introduction: lumbar spinal stenosis (LSS) is the most frequent cause in patients > 65 years of age who require surgical treatment. Objective: to present the pre- and postoperative symptomatology and functionality of patients with degenerative LSS treated at our institute. Material and methods: descriptive, retrospective and observational study, carried out in the traumatology and orthopedics service. Data were obtained in a period from January 2022 to January 2023. We selected patients diagnosed with degenerative LSS, with at least six months of unsuccessful conservative treatment who underwent surgical treatment; we collected data on gender, age, occupation, pre- and post-surgical symptoms, instrumented levels and Oswestry Disability Index (ODI) pre and post-surgical at 6 and 12 months. Results: 40 patients with degenerative LSS underwent recalibration, ligamentoplasty and posterolateral arthrodesis with instrumentation with screws and bars. Most frequent instrumented levels: L3-L5 (35%) and 5-S1 (10%). Gender distribution: 42.5% men, and 57.5% women. Before surgery: 80% with low back pain intensity 7/10 and 20% with 8/10 on the numerical pain scale; strength in pelvic extremities: 65% with 4/5 on the Daniels scale, six cases with paresthesias in both legs. Six months after surgery, 85% reported pain intensity 3/10 and 15% 4/10. The 26 patients with strength 4/5 improved to 5/5. Paresthesias disappeared in five of six patients. The pre-surgical ODI was 42% on average. It was 25% at six months, and 18% 12 months after surgery. Conclusions: when conservative treatment fails, surgery provides a favorable functional evolution.


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