[Utility of ligamentoplasty for the prevention of adjacent segment disease above 360 degree arthrodesis in degenerative lumbar spondylosis. Preliminary report]. / Utilidad de la ligamentoplastía para la prevención de la artrodesis en espondilolistesis lumbar degenerativa. Reporte preliminar.

BACKGROUND: Ligamentoplasty is a dynamic stabilization method used to treat lumbar stenosis and resect lumbar herniated discs with good results. The objective of this paper is to report preliminary results of the utility of ligamentoplasty to prevent adjacent segment disease above the arthrodesis. MATERIAL AND METHODS: Two groups of patients with degenerative lumbar spondylolisthesis who underwent circumferential arthrodesis. In 23 patients a dynamic stabilization system was placed in the segment above (group L), while this system was not used in 35 patients (group S). Degeneration and disease of the segment above were assessed. The statistical analysis was done with the SPSS 15.0 software. RESULTS: At the one-year follow-up, the incidence rate of adjacent segment degeneration was 11% for group L and 0% for group S; at the two-year follow-up it was 13% in both groups; at three years, 0% for group L and 19% for group S; at four years, 25% for group L and 0% for group S. At five years, 50% for group L and 0% for group S. Clinically significant radiculopathy occurred in two patients five years after surgery, one of whom also had adjacent segment disease. CONCLUSIONS: Based on the follow-up, at this moment it is not possible to show the utility of dynamic stabilization through ligamentoplasty to avoid adjacent segment disease above the arthrodesis.

[Comparison of three types of lumbar total disc arthroplasty. Four-year minimum follow-up]. / Comparación entre tres tipos de artroplastía total de disco lumbar. Seguimiento mínimo de 4 años.

BACKGROUND: Total lumbar disc replacement was developed to avoid the drawbacks of arthrodesis. This procedure should be done cautiously due to the various already known complications. The purpose of this study is to assess the clinical and radiographic results after single-level lumbar arthroplasty with the Prodisc-L, Maverick and Charité prostheses at our service. MATERIAL AND METHODS: A retrospective study was performed comparing the clinical and radiographic results of three groups of patients who underwent total lumbar disc arthroplasty from January 2000 to December 2007. RESULTS: Twenty-one lumbar prosthetic surgeries were performed. The Prodisc device was used in 13 patients, the Maverick in 4, and the Charité in 4. After the application of the Stauffer-Coventry scale, 16 patients reported excellent results and 5 good results. The mean preoperative interbody height was 7.9 mm and the mean postoperative height was 12.91 mm. The mean differential angle in the dynamic films was 5.47 degrees preoperatively and 4.61 postoperatively; the mean angle in neutral position was 13.38 preoperatively and 19.61 postoperatively. CONCLUSIONS: This study showed that the clinical result was good in all three groups. Mobility was better maintained with the Charité prosthesis compared to the Prodisc and Maverick devices. The three prostheses are appropriate for the treatment of lumbar degenerative disc disease.