RESUMEN
In the treatment of lumbar stenosis the method known as "recalibrage" proposed by Senegas is the most recent alternative to extended traditional laminectomy. Posterior decompression, which is obtained by removal of the cephalic half of the laminae, the yellow ligaments and the intraforaminal part of the facet joint, reduces the risk of postsurgical instability and makes it possible to proceed with fusion which is not just posterolateral. In cases where there is intersegmental instability we applied the Hartshill rectangle, proposed by Doce, stabilized to the residual laminar and associated with genous grafting. Our experience is based on 48 cases treated with this method over the last three years. In 19 cases Hartshill fixation was used to complete "recalibrage". Results are generally satisfactory, although follow-up is short. The "relative gain" method proposed by Lassale and Garcon was used for evaluation.
Asunto(s)
Estenosis Espinal/cirugía , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Laminectomía/métodos , Laminectomía/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Inducción de Remisión , Fusión Vertebral/métodos , Fusión Vertebral/estadística & datos numéricos , Estenosis Espinal/diagnóstico , Estenosis Espinal/epidemiologíaRESUMEN
Degenerative or inflammatory diseases of the knee joint account for a large proportion of diseases affecting the elderly. Treatment aims to eliminate pain, correct the deformity and maintain complete joint mobility. In cases of total joint degeneration, fitting of a joint prosthesis is the technique currently favoured since elimination of pain and correction of the deformity, accompanied by recovery of joint mobility (the fundamental requirements for normal everyday life) can only be obtained if the knee joint is completely replaced. With the discovery of new materials and increasingly sophisticated knowledge about articular mechanics, the knee prosthesis, although more recent than the hip prosthesis, has become ever more widespread to the point that it now represents an irreplaceable aid in the treatment of this common disease. The clinical results obtained are already stable and particularly encouraging and prosthesis design is sophisticated and accurate. There is, however, still the suspicion that current prostheses can be considered "rudimentary" in comparison with the physiological and biomechanical behaviour of the human joint. We therefore wanted to begin an evaluation using a gait analysis system to assess patients fitted with knee prostheses. The first impressions gained in this study are the subject of this article.