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Vol. 17. Issue 3.
Pages 232-239 (January 2006)
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Vol. 17. Issue 3.
Pages 232-239 (January 2006)
Causas de reintervención quirúrgica en pacientes con fijación lumbar intervenidos por estenosis de canal
Causes of reoperations in patients with lumbar spinal stenosis treated with instrumentations
Visits
1986
A. Gómez de la Riva
, A. Isla, C. Pérez-López, R. Ortega, J.C. Fernández-Miranda, J. Heredero
Servicio de Neurocirugía. Hospital Universitario La Paz. Madrid
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Resumen
Objetivo

En el presente trabajo analizamos las causas por las que se ha debido reintervenir a pacientes diagnosticados de estenosis de canal que habían sido tratados mediante descompresión quirúrgica y fijación lumbar.

Material y métodos

Seleccionamos 74 pacientes entre enero de 1996 y diciembre de 2000 con un seguimiento mínimo de 4 años.

Resultados

16 (21,1%) fueron sometidos a una nueva intervención quirúrgica. La principal causa fue la estenosis de niveles adyacentes superiores a la instrumentación (en el 50%). Otras causas fueron la fibrosis perirradicular, la persistencia de estenosis tras la cirugía, el dolor neuropático, la desconexión del sistema de fijación, la compresión radicular por tornillos transpediculares y la rotura de tornillos.

Conclusiones

Las complicaciones relacionadas con la técnica quirúrgica son bajas ya que la mitad de las reintervenciones en pacientes con estenosis del canal lumbar está producida por la estenosis del segmento superior a la fijación.

Palabras clave:
Estenosis lumbar
Instrumentación
Reintervención
Estenosis del nivel superior
Summary
Objective

In present study we analyzes the causes leading to reoperation patients treated for lumbar spinal stenosis with laminectomy and lumbar instrumentation.

Material and methods

74 patients operated between January of 1996 and December of 2000 with a minimum 4 year follow-up were seleted for the study.

Results

16 patients (21 1%) underwent a new surgical intervention. The main cause for reoperation was stenosis of the adjacent level superiorly to the instrumentation (in 50%). Other causes were radicular fibrosis, persistence of stenosis after the surgery, neuropatic pain, failure of the instrumentation system, transpedicular screws misplacement and break of screws.

Conclusions

Complications related with the initial surgical procedure are low, as half of the reoperations were due to stenosis of the segment superior to the fixation.

Key words:
Lumbar spinal stenosis
Instrumentation
Reoperation
Adjacent level

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