10
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      To submit to this journal, click here

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Étude rétrospective concernant la prise en charge chirurgicale des lombosciatiques communes dans le Département d'Orthopédie de Tataouine, Tunisie: à propos de 44 cas Translated title: Retrospective study of surgical management of lumbosciatica in the Department of Orthopaedics in Tataouine, Tunisia: about 44 cases

      case-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          La lombosciatique commune représente un problème de santé publique par son retentissement socioprofessionnelle. Le but de notre travail est d'étudier l'indication du traitement chirurgical et la place de chaque technique utilisé. Il s'agit d'une étude rétrospective réalisée au Service d'Orthopédie de Tataouine, concernant 44 patients présentant une lombosciatique commune et ayant eu un traitement chirurgical durant la période allant de 2013 à 2018. La fiche de renseignement a inclus les données épidémiologiques et les données cliniques. Les patients ont eu un bilan radiologique comportant une radiographie du rachis lombaire face et profil et une tomodensitométrie (TDM) lombaire qui a précisé l'étiologie de la sciatalgie commune. Le traitement chirurgical a été indiqué après échec d'un traitement médical, en cas de sciatique hyperalgique et en cas de complication neurologique. Dans notre étude, la hernie discale était la principale étiologie de lombosciatique (50% des cas) suivie par le canal lombaire étroit (25%), le spondylolisthésis (22,7%) et la méga apophyse transverse de L5 (2,3%). La dissectomie classique était la technique utilisée pour la cure chirurgicale des hernies discales. Huit patients présentant un spondylolisthésis ont bénéficié d'une laminectomie associée à une arthrodèse postérieure. Pour la cure chirurgicale de canal lombaire rétréci, on a pratiqué une laminectomie seule dans 54,54% des cas. L'évolution au recul a été favorable dans 90% des cas l'échelle visuelle analogique (3±1 au recul). Le choix des techniques chirurgicaux dépend de l'étiologie et des données de l'imagerie qui imposent le choix des étages de l'arthrodèse.

          Translated abstract

          Lumbosciatica is a public health problem because of its socio-professional impact. The purpose of our study is to evaluate the indication for surgical treatment and the role of each technique used. We conducted a retrospective study in the Department of Orthopaedics in Tataouine. The study involved 44 patients with common lumbosciatica and having undergone surgical treatment over the period from 2013 to 2018. The information sheet included the epidemiological data and the clinical data. The patients underwent radiological assessment including lumbar spine x-ray (frontal and lateral views) and lumbar computed scan (CT) scan which clarified the cause of sciatica. Surgical treatment was indicated after medical treatment failure, in patients with hyperalgesia and in patients with neurological complication. In our study, herniated disc was the primary cause of lumbosciatica (50% of cases) followed by lumbar spinal stenosis (25%), spondylolisthesis (22.7%) and transverse mega-apophysis of L5 vertebrae (2.3%). Traditional discectomy was the most used technique for surgical treatment of herniated disc. Eight patients had spondylolisthesis. They underwent laminectomy associated with posterior arthrodesis. Lumbar spinal stenosis was treated with laminectomy alone in 54.54% of cases. Outcome was favorable during the follow up period in 90% of cases (Visual Analog Scale 3±1 at follow-up). Surgical technique depends on etiology and imaging data on which to base the choice of arthrodesis stages.

          Related collections

          Most cited references16

          • Record: found
          • Abstract: not found
          • Article: not found

          Clinical practice. Lumbar spinal stenosis.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Complications and readmission after lumbar spine surgery in elderly patients: an analysis of 2,320 patients.

            There is a paucity of literature describing risk factors for adverse outcomes after geriatric lumbar spinal surgery. As the geriatric population increases, so does the number of lumbar spinal surgeries in this cohort.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Surgical outcome of 438 patients treated surgically for lumbar spinal stenosis.

              A retrospective, follow-up study. To investigate the overall outcome of surgery for lumbar spinal stenosis and to investigate the preoperative factors affecting outcome. The success rates of surgical intervention for lumbar spinal stenosis vary, and few preoperative factors have been found to be significantly correlated to surgical outcome. A total of 438 patients (183 women, 255 men) who underwent decompressive surgery for lumbar spinal stenosis were re-examined and evaluated for outcome 4.3 years after surgery. Outcome was based on subjective disability, which was assessed using the Oswestry low back pain questionnaire. The preoperative data (clinical documentation, length of laminectomy, and radiographs) were collected from patient records that had been stored in the hospital. Preoperative factors affecting outcome were reported. The mean value of the Oswestry disability score of these 438 patients was 34 +/- 18 (women, 36.3 +/- 17; men, 32.3 +/- 18; P < 0.05). Age did not influence general outcome. The proportion of good to excellent outcomes of all 438 patients was 62% (women, 57%; men, 65%). Diabetes, hip joint arthrosis, and preoperative fracture of the lumbar spine seemed to be associated with poor outcome. The ability to work before or after surgery and a history of no prior back surgery were predictive of good outcome. The results suggest that clear myelographic stenosis and no prior surgical intervention, no comorbidity of diabetes, no hip joint arthrosis, and no preoperative fracture of the lumbar spine are factors associated with a good outcome in surgical management of lumbar spinal stenosis.
                Bookmark

                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                07 April 2020
                2020
                : 35
                : 103
                Affiliations
                [1 ]Service de Chirurgie Orthopédique et Traumatologie, Hôpital Régional de Tataouine, Tataouine, Tunisie
                [2 ]Service de Chirurgie Orthopédique et Traumatologie, CHU Habib Bourguiba, Sfax, Tunisie
                Author notes
                [& ]Auteur correspondant: Nizar Sahnoun, Service de Chirurgie Orthopédique et Traumatologie, CHU Habib Bourguiba, Sfax, Tunisie
                Article
                PAMJ-35-103
                10.11604/pamj.2020.35.103.22510
                7320770
                ca7a4ec3-7486-4e23-87ad-f02d08a87d56
                © Mourad Hammami et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 March 2020
                : 01 April 2020
                Categories
                Case Series

                Medicine
                lombosciatiques communes,chirurgie,indication,lumbosciatica,surgical
                Medicine
                lombosciatiques communes, chirurgie, indication, lumbosciatica, surgical

                Comments

                Comment on this article