Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 24046
RETROSPECTIVE ANALISIS OF THE COMBINED DYNAMIC/RIGID TREATMENT
OF MULTIPLE LUMBAR DISCAL HERNIAS.
Hector Francisco GUTIERREZ GUTIERREZ 1 , Jannethe MORALES 1 , Alfredo ORTIZ
FLORES 2
1 Hospital General de Pachuca Hidalgo, Pachuca Hidalgo (MEXICO), 2 Centro Medico
Toluca, Metepec (MEXICO)
OBJECTIVE: Evaluate evolution of the surgical treatment rigid/dynamic of multiple
lumbar discal hernias.INTRODUCTION: Overload in lumbar region, generated by
obesity, hyperlaxitud and sedentarism, by itself onset an early mechanical
segmentary instability between L4-L5 and discartrosis L5-S1, resulting multiple discal
hernias with neural compromise and premature degeneration in young population.
achiving a functional combined dynamic/rigid treatment with biomechanical changes,
posterior the neural liberation, consisting in circumferencial arthrodesis 270°, changin
the vertical force that lays on L5-S1 to L4-L5, increasing the transversal support and
decreasing the cutting forces, plus the decrease, the lumbar hyperlordosis, with
interespinous plasticligamentoplasty, mantains the movility at L4-L5. MATERIAL AND
METHODS: retrospective study, descriptive, at agust 2002 to october 2008. Patients
with multiple lumbar hernias with neural compromise, mechanical segmentary
instability of L4-L5 and discarthrosis L5-S1, diagnosed by physical exam, x-rays, MRI
and electromiography. performing combined rigid/dynamic surgical treatment and
neural liberation. RESULTS: 24 Patients, 10 male, 14 female, 24 Double hernias L4-
L5 and L5-S1 discarthrosis and instability 24 Performed surgeries circumferential
arthrodesis 270° L5-S1 ligamentoplasty L4-L5With p ain, 21 medium decreases 3
late decrease 24 functional estability L4-L524 radiografic consolidation arthrodesis
and stabilization L5-S1. Rehabilitation: 22 improvement, 22 physical reinorporation to
activities, 2 late control and late recovery. CONCLUSIONS: Is a usefull and resolutive
tecnnique for premature onset, obesity and sedentarism.surgical option based on
valid rachideal biomechanics and a logical aplication.
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