RESUMO
The authors report about 139 cases of nerve root compression due to a lumbar stenosis of the lateral recess. Saccoradiculography seems to be the best examination technique, and the radioclinical agreement is satisfactory. The technique for the surgical treatment and the extent of the release are described. Decompression must involve the symptomatic nerve roots, as well as those who appear to be displaced or amputated on radiculography. The only prognostic element noted in this study is the duration of evolution of preoperative symptoms. Thus the results may be less good for radicular pain lasting for more than one year.
Assuntos
Síndromes de Compressão Nervosa/etiologia , Polirradiculoneuropatia/etiologia , Estenose Espinal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Raízes Nervosas Espinhais/diagnóstico por imagem , Estenose Espinal/complicaçõesRESUMO
Eighty-eight patients (52 men, 36 women) were operated on for lateral recess syndrome, during the 1970-1986 period. 7 had priorly a disc excision; in 11 a chemonucleolysis had been performed. The pain affected one nerve root in 41 cases, two in 8, three in 1. In 33 patients the pain pattern was incomplete. Myelography was used in 77 cases, and was positive in 68. CT scan was used in 43 cases. A posterolateral fusion was added to the unroofing of the nerve in 9 patients, who had severe low back pain before surgery. The results were assessed with a special rating scale of 20 points. They were considered excellent or good in 70 per cent. 6 patients were reoperated from 3 months to 2 years post-operatively mainly for recurrent pain at another level or side.
Assuntos
Radiculopatia/etiologia , Ciática/etiologia , Estenose Espinal/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radiculopatia/diagnóstico por imagem , Radiculopatia/cirurgia , Ciática/diagnóstico por imagem , Ciática/cirurgia , Raízes Nervosas Espinhais/diagnóstico por imagem , Estenose Espinal/cirurgia , Tomografia Computadorizada por Raios XRESUMO
In a case of partial laminoarthrectomy for lateral recess stenosis cauda equina compression occurred post-operatively, and was caused by migration of a free graft. Recovery was complete within six months. The technical details of insertion of the free fat grafts are described.
Assuntos
Tecido Adiposo/transplante , Cauda Equina , Laminectomia , Síndromes de Compressão Nervosa/etiologia , Complicações Pós-Operatórias/etiologia , Idoso , Feminino , HumanosAssuntos
Ciática/etiologia , Estenose Espinal/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Ciática/diagnóstico por imagem , Ciática/cirurgia , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/cirurgia , Tomografia Computadorizada por Raios XRESUMO
The authors report two new cases of splenic epidermoid cyst. They stress the importance of sonography and the need for thorough examination of the surgical specimen for establishing the diagnosis. They also discuss several etiological hypotheses. Although uncommon, the possibility of an epidermoid cyst must always be considered once the echinococcal nature of the cyst has been ruled out, in all cases of splenic cysts in children or young adults.
