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Formes particulières de canaux lombaires étroits

The various forms of lumbar spinal stenosis

  • Dossier Thématique
  • Published:
La Lettre de médecine physique et de réadaptation

Résumé

Le canal lombaire étroit, sous sa forme classique décrite par Verbiest [1], correspond au canal lombaire étroit dégénératif, arthrosique. L’évolution des connaissances, des moyens d’investigations, en particulier d’imagerie, et des techniques chirurgicales ont permis d’analyser les sténoses lombaires en fonction de différents critères (anatomiques, mécaniques, terrain…). Ainsi, il n’existe pas « un » mais « des » canaux lombaires étroits dont l’analyse clinique mais surtout radiologique doit être complète avant toute proposition de traitement chirurgical. Nous nous sommes proposés d’étudier dans ce cours chapitre, de façon arbitraire, les canaux lombaires étroits constitutionnels et les canaux étroits associés à une déformation scoliotique. Par ailleurs, les praticiens sont confrontés à la survenue de ces pathologies chez des patients de plus en plus âgés et demandeurs d’une autonomie et d’un confort de vie, qui font discuter le traitement chirurgical de sténoses lombaires à un âge avancé. Les auteurs analysent, à l’appui des données de la littérature, les possibilités thérapeutiques chez ces patients.

Abstract

The narrow lumbar canal, in its most common form described by Verbiest [1], consists of a degenerative narrow canal with arthrosis. Advances in knowledge, investigative technology — especially imaging — and surgical techniques have made it possible to analyze lumbar stenoses based on a number of criteria (anatomical, mechanical, environmental, and others). This has revealed the existence of more than one form of the narrow lumbar canal, which clinical analysis, especially radiological, must identify before any surgical intervention. In this short chapter, we take a general look at congenital narrow lumbar canals and those associated with malformation from scoliosis. Practitioners must now treat increasingly older patients presenting with these disorders and seeking autonomy and relief from discomfort; this has created controversy about the surgical treatment of stenoses at advanced ages. We analyze the therapeutic alternatives for these patients by reviewing data found in the literature.

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Authors and Affiliations

  1. Service d’orthopédie, CHU Pitié-Salpêtrière, pavillon Gaston-Cordier, boulevard de l’Hôpital, Paris, France

    H. Pascal-Moussellard, J. -Y. Lazennec & Y. Catonné

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  1. H. Pascal-Moussellard
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  2. J. -Y. Lazennec
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  3. Y. Catonné
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Corresponding author

Correspondence to H. Pascal-Moussellard.

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Pascal-Moussellard, H., Lazennec, J.Y. & Catonné, Y. Formes particulières de canaux lombaires étroits. Lett Med Phys Readapt 23, 12–15 (2007). https://doi.org/10.1007/s11659-007-0053-z

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  • DOI: https://doi.org/10.1007/s11659-007-0053-z

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