Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Jan 1988
Review[Chronic medullary neuro-stimulation in lumbosacral spinal arachnoiditis].
Between 1983 and 1986, 20 patients were treated by chronic spinal cord stimulation for the relief of pain. These patients suffered from lumbar arachnoiditis or root fibrosis causing lumbar pain and sciatica following operations for disc herniation or repeated radiculography. In this short series, the results obtained were satisfactory, with 12 good results which were stable over a 2-year period, thanks to careful selection of the subjects within the framework of a multidisciplinary pain clinic. The treatment of the fibrosis and the mechanism of neurostimulation are reviewed.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2000
Comparative Study[Bankart procedure: clinical and radiological long-term outcome].
There are few reports onlong-term outcome after Bankart procedure. The purpose of this study was to determine the rate of recurrent dislocation, the clinical results and the incidence of glenohumeral osteoarthritis after a minimum 10-year follow-up. ⋯ In our hands the Bankart procedure is appeared as a safe procedure with a low rate of glenohumeral osteoarthritis and a high rate of patient satisfaction.
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Rev Chir Orthop Reparatrice Appar Mot · May 2007
Comparative Study[Prospective and comparative study of minimally invasive posterior approach versus standard posterior approach in total hip replacement].
There have been few prospective studies comparing minimally invasive approaches for total hip replacement. We wanted to ascertain the contribution of the minimally invasive posterior approach in comparison with the standard posterolateral approach in terms of early outcome. ⋯ The minimally invasive posterior approach does not require an orthopedic table nor specific instrumentation. A minute procedure is required with ligature of the posteromedial circumflex artery of the thigh to improve exposure and limit intraoperative bleeding. It enables satisfactory reproducible implant positioning. Conversion to an open posterolateral approach is possible if needed. The minimally invasive posterior approach enables a reduction in intraoperative bleeding and in postoperative pain while allowing earlier more rapid rehabilitation. Early clinical outcome is better but beyond six weeks, the functional results are comparable for the two approaches. The minimally invasive posterior approach is a reliable reproducible approach with a progressive learning curve.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2008
Comparative Study[Long-term survival analysis after surgical management for degenerative lumbar stenosis].
The short- and mid-term symptom-relief of surgical treatment for lumbar stenosis is generally acknowledged, but the probability of a long-term reoperation remains to be studied. The purpose of this work was to determine the long-term risk of reoperation after surgical treatment of degenerative lumbar stenosis and to search for factors influencing this probability. ⋯ The study included 262 patients. At last follow-up, 61 patients had died a mean 3.7+/-3 years after the operation; only one of these patients had a second operation 22 months after the first. Forty-four patients were lost to follow-up at mean 6.6+/-3 years. Among these 44 patients, four had a second operation during their initial follow-up at mean 47 months. One hundred fifty-seven patients were retained for this analysis at mean 15+/-1 years follow-up. Among these 157 patients, 29 had a second operation a mean 75 months after the first. There were four reasons for reoperating: insufficient release, destabilization within or above the zone of release, development or renewed zone of stenosis, development or renewed discal herniation. The risk of a second operation was 7.4% [95% CI 4.8-11.6], 15.4% [95% CI 10.7-21.1] and 16.5% [95% CI 11.7-219] at five, 10 and 15 years respectively after the first operation. Among the risk factors studied, only one had a significant impact on reoperation: extent of the zone of release (p=0.003). Compared with a release limited to one level, the risk of reoperation after release of three levels or more was five times greater [95% CI 1.8-12.7].
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Rev Chir Orthop Reparatrice Appar Mot · May 2003
Comparative Study Clinical Trial[Validation of a tool to measure pelvic and spinal parameters of sagittal balance].
Parameters determining sagittal balance are essential for optimal analysis and treatment of many spinal disorders. The purpose of this work was to validate a software designed to measure the principal parameters involved in sagittal balance of the spine. ⋯ This comparison between two techniques for measuring pelvic and spinal parameters of sagittal balance of the spine demonstrated a good correlation between manual and the computerized measurements obtained with the software to be evaluated. Computer-assisted measurements not only provided a saving in time but also minimized inter- and intra-observer variability for the estimation of certain parameters.