| Autor: |
Jacques Lenelle, Bruno Kaschten, Félix Scholtes, S. Borlon, Annie Dubuisson, Tudor Racaru, Adrienne Henroteaux, M. Nguyen Khac, Didier Martin |
| Rok vydání: |
2012 |
| Předmět: |
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| Zdroj: |
World Neurosurgery. 77:206 |
| ISSN: |
1878-8750 |
| Popis: |
INTRODUCTION: Foot drop from lumbar disc herniation (LDH): whatandwhentodo?OurobjectiveistoevaluatetheprognosticfactorsofmotorrecoveryincaseofparalysingLDH. MATERIAL AND METHODS: 30 charts were retrospectively reviewed ofpatients suffering of LDH with motor deficit. We excluded LDH with caudaequinasyndrome. RESULTS: There were 20 men and 10 women. Mean age was 48 years(25–84).16patientsconsultedtheemergencydepartmentwhile14wereseeninclinics.21patientssufferedoflumbarpain,18ofradicularpainandallofa mild/moderate (6) or severe (24) motor deficit, implying mostly the ankleflexion(21).LDHwasmostfrequentlylocatedatL4L5(47%)orL5S1(40%)level. Surgery was proposed to 27 patients at the end of the consultation. 9patientswereoperatedwithin48hours.Themeanintervalbetweenonsetofmotor deficit and operation was 20 days (0–90). The 6 patients with mild/moderatedeficitrecoveredwelland17ofthe24patientswithseveredeficit.The statistical analysis did not bring out any significant difference as foroperativedelayinparticular. CONCLUSION: ParalysingLDHisconsideredasurgicalfunctionalemer-gencybythemajorityofspinesurgeons.However,evidencebasedmedicinestudies are lacking. A prospective study on 116 patients concluded that thedegree of recovery of motor function is inversely related to the preoperativeseverityanddurationofmuscleweakness.Arelativeconsensusexistsamongspine surgeons for paralysing LDH: since operative indication is obvious,surgeryshouldbedoneassoonaspossible. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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