Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2002
[Validation of a self-administered functional evaluation questionnaire after surgical treatment of lumbar spine stenosis].
The main aim of this prospective, multicentric, observational study was to validate a self-administered quality-of-life questionnaire for patients with lumbar spine stenosis treated surgically. ⋯ Associating a simple 8-question self-administered questionnaire with an index of satisfaction (4 questions) and an objective index of neurological involvement provided a reliable, sensitive, and reproducible assessment of the changes in functional disorders resulting from lumber stenosis before and after surgical treatment.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2002
Comparative Study[Surgical decompression of cervical arthrotic myelopathies: comparison of surgical anterior and posterior approaches].
Operative treatment of cervical myelopathy has focused on decompression of the spinal cord to avoid neurological deterioration. Anterior or posterior operative techniques have been used to decompress the canal with variable success. The purpose of this study was to compare surgical results after subtotal corporectomy or discectomy with an anterior approach and laminectomy or laminoplasty with a posterior approach. ⋯ Surgical treatment is effective in cervical spondylolitic myelopathy. The anterior approach is preferred in case of pain or brachialgia; the posterior approach is indicated in case of poor health status or for bedridden patients.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2002
[Mid-term results of shoulder arthroplasty for primary osteoarthritis].
Primary osteoarthritis of the glenohumeral joint is less common than that of the hip and knee, but it is not so rare. The use of prosthetic arthroplasty for the management of end-stage osteoarthritis remains the treatment of choice. We reviewed our experience of shoulder arthroplasties in 48 patients (51 shoulders) with 60 months average follow-up (24-124). ⋯ Shoulder arthroplasty has become the standard for the treatment of primary osteoarthritis. Proximal humeral head prosthetic replacement can be a very successful procedure in patients with glenohumeral arthritis; however the degree and consistency of pain relief is not as great nor as predictable as in total shoulder arthroplasties. Also, clinical results seem to deteriorate with time. Revision rate is approximatively of 20%, usually for persistant pain. The clinical results of total shoulder arthroplasty continue to be excellent with longer follow-up period. The frequency of complications and the need for revision is low. However, when revision surgery is needed, the most common reason is for glenoid loosening. Good results can be expected especially in primary osteoarthritis with pain relief in almost all cases, good motion (three-fourths or four-fifths normal), improvement of functional activities, and patient satisfaction in at least 90% of the cases.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2002
Case Reports[Operative exposure of the posteromedial part of the proximal humeral diaphysis using an extended deltopectoral approach].
Total resection of a massive osteochondroma situated in the posteromedial part of proximal humeral shaft was achieved via an extended deltopectoral approach. We discuss the surgical approach to the posteromedial part of the proximal humeral diaphysis by type of lesion to operate.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2002
[Systematic circumferential (360 degree) decompression treatment of major arthrotic cervical stenosis].
Worsening and irreducible evolution of neural involvement in cervical stenosis requires cord decompression. Different techniques have been proposed. We associated a dual posterior then anterior approach to achieve 360 degrees decompression. We evaluated results on the basis of neurological and mechanical outcome. ⋯ 360 degrees arthrodesis for severe cervical canal stenosis provides a satisfactory solution to mechanical problems and substantial neurological improvement. Fusion is regularly obtained without complementary anterior instrumentation. Neurological improvement is correlated with disease duration and the degree of deficit at onset. Anteroposterior decompression and 360 degrees fusion provide cure for all the components of stenotic disease. The dual approach is indicated in severe cases with cord involvement as recognized by myleopathic clinical manifestations and on the MRI.