RESUMO
Objetivo: Determinar la incidencia y el grado de recrecimiento óseo que ocurre en el sitio de la laminectomía después de efectuar cirugía descompresiva para la estenosis del canal lumbar e investigar la existencia de posibles factores que pueden promover dicho recrecimiento y sus posible influencia en la evolución clínica. Material y método: Se revisaron 29 pacientes operados por estenosis lumbar, con un seguimiento de 6,6 años. Se compararon las imágenes radiográficas del arco posterior del postoperatorio inmediato con las obtenidas en el último control. El recrecimiento se evaluó como un porcentaje del hueso recrecido con el defecto de la laminectomía original. Se establecieron 4 grados: Insignificante 0-10%, leve 11-40%, moderado 41-70%, grave 71-100%. Se analizaron los aspectos relacionados con el sexo, etiología de la estenosis, número de niveles, tipo de cirugía, grado de recrecimiento y clínica del último control. Resultados. En 9 casos no se observó recrecimiento o era insignificante, en 18 se calificó como leve y en 2 como moderado. No se encontró ningún caso grave. El grado de recrecimiento estaba relacionado con el número de niveles intervenidos y con la práctica o no de artrodesis. El grado de recrecimiento leve y moderado ha tenido peores resultados que el grupo de recrecimiento insignificante. Conclusión: el recrecimiento óseo parece ser un factor de deterioro de la clínica, aunque el resultado de nuestro estudio no es estadísticamente significativo
Objective: To determine the incidence and the amount of bony regrowth occurring at the site of laminectomy after performing decompressive surgery for lumbar spinal stenosis and to investigate the existence of possible factors that could enhance such bony regrowth and its possible influence in clinical outcome. Methods: Bone regrowth was assessed in 29 patients (mean follow-up 6,6 years) that underwent decompressive surgery due to lumbar spinal canal stenosis. Postoperative plain films were compared with plain films obtained at the last follow-up. Bone regrowth was graded relating to the percentage of new bone created at the site of the laminectomy being divided into four categories: insignificant 0-10%, mild 11-40%, moderate 41-70% and severe 71-100%. Different factors such as gender, spinal stenosis etiology, number of levels involved in surgery, degree of bony regrowth and patient clinical condition at the last follow-up were analyzed. Results: In 9 patients none or insignificant bony regrowth was observed, 18 patients were included in the mild category whereas 2 patients were included in the moderate category. No case of severe regrowth was identified. The degree of bony regrowth was found to be related with the number of levels included in the surgery and with the performance or not of spinal arthrodesis. Regarding clinical outcome those patients showing mild to moderate bone regrowth showed a worse clinical outcome than those who presented insignificant amounts of bony regrowth. Conclusions: Although the results of the present study are not statistically significant it seems that the occurrence of bony regrowth at the site of laminectomy might be a deleterious factor for clinical outcome in those patients who underwent decompressive surgery for lumbar spinal stenosis
