Aloulou, I.

Dziri, C.

Lebib, S.

Mahersi, S.

Miri, I.

Salah, F.Z. Ben

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Conservative treatment of lumbar radicular pain on lumbar spinal stenosis 

Pathologies rachidiennes (II) / Revue d’E´pide´miologie et de Sante´ Publique 55S (2012) e282–e289e288Pour en savoir plus
Altiok H, et al. The superior mesenteric artery syndrome in patients with spinal
deformity. Spine 2005;30(19).
de Mauroy, et al. Brace Technology. Thematic Series – The Lyon approach to
the conservative treatment of scoliosis. Scoliosis 2011;6(1).
http://dx.doi.org/10.1016/j.rehab.2012.07.725
P074-f
Re´cidives des lombosciatalgies communes au Be´nin
G.T. Kpadonou a, E. Alagnide´ a,*, S. Gbe´nou b, E. Fiossi-Kpadonou c,
G. Houngbedji a, D. Niama a, R. Bognon a
a Service de re´e´ducation et de re´adaptation fonctionnelle du CNHU,
Cadje`houn, 04 BP 808 Cotonou, Be´nin
bHoˆpital de la me`re et de l’enfant de la Lagune (Homel) de Cotonou, Be´nin
c Service de psychiatrie, Be´nin
*Auteur correspondant.
Adresse e-mail : kpadonou_toussaint@yahoo.fr.
Mots cle´s : Lombosciatalgies ; Re´cidives ; Hygie`ne du dos ; Cotonou
La lombosciatalgie est une pathologie ubiquitaire potentiellement invalidante.
Indépendamment du traitement rec¸u, elle est souvent récidivante [1].
Objectif.– Analyser les aspects épidémiologiques, cliniques et évolutifs des
récidives des lombosciatalgies communes suivies en rééducation au CNHU de
Cotonou.
Me´thode.– Étude rétrospective à visée descriptive et analytique, ayant porté sur
126 cas de récidives de lomboscialgies (41 opérés et 85 non opérés) suivis dans
le service de rééducation du CNHU de Cotonou, entre janvier 1998 et décembre
2008.
Re´sultats.– La majorité des sujets était âgée de 40 à 59 ans et de sexe féminin
avec une sex-ratio de 0,66. La fréquence des récidives de lombosciatalgies a été
de 11,02 % chez les non opérés et 8,17 % chez les opérés (p = 0,11). La récidive
est survenue en moyenne à 2,01  1,60 ans, surtout en l’absence de respect des
conseils d’hygiène du dos (p = 109). Les ouvriers (25,4 %) et les employés de
bureau (18,2 %) ont été les plus touchés. L’atteinte a été bilatérale (47,6 %),
unilatérale droite (30,2 %). La racine touchée a été unique dans 83,3 %, dont L4
(7,1 %), L5 (62,7 %), S1 (13,5 %) et double (L5 et S1) dans 16,7 %. Ont été
associés à la douleur, claudications intermittentes (61,9 %), paresthésies
(33,3 %), déficit moteur (31,0 %), amyotrophie (10,3 %), perturbation des
réflexes (38,1 %), troubles sensitifs (35,7 %) et positivité du Lasègue (47,6 %).
L’évolution des récidives des lombosciatalgies a été peu satisfaisante et a été
conditionnée par le respect des conseils d’hygiène du dos.
Discussion-Conclusion.– L’absence de différence significative dans la survenue
des récidives des lombosciatalgies entre opérés non opérés et la forte influence
des règles d’hygiène du dos tant dans leur apparition que leur évolution
suggèrent : l’importance de l’affinement des indications opératoires et de
l’observance des règles d’hygiène du dos.
Référence
[1] Javier RM. Les lombosciatiques. Rev Rhum 2004;71:72–6.
http://dx.doi.org/10.1016/j.rehab.2012.07.726
English version
P072-e
Conservative treatment of lumbar radicular pain
on lumbar spinal stenosis
S. Mahersi a, I. Aloulou a, S. Lebib a, I. Miri a, F.Z. Ben Salah b, C. Dziri a,*
a Service de me´decine physique et re´adaptation fonctionnelle, institut national
d’orthope´die M. Kassab, 2010 La Manouba, Tunis, Tunisia
b Institut de promotion des handicape´s, La Manouba, Tunis, Tunisia
*Corresponding author.
E-mail address: catherine.dziri@rns.tn.
Keywords: Lumbosacral radicular pain; Spinal stenosis; Disability;
Conservative treatmentIntroduction.– Lumbar spinal stenosis can cause lumbosacral radicular pain.
The management remains controversial among conservative treatment and
surgical treatment.
Materials and methods.– Retrospective study of 25 patients hospitalized
between January 2010 and December 2011 in a department of Physical
Medicine and Rehabilitation, for radicular lumbosacral pain due to lumbar
spinal stenosis, assessed by epidemiological data, functional symptoms, data
from the clinical, X Ray and prior treatments. Therapeutic response was
assessed by subjective improvement in pain and improvement of the clinical
syndrome.
Results.– Twenty-five patients: 16 women and 9 men, mean age 52.6 years
(between 31 and 76 years). The lumbosacral radicular pain was unilateral in 14
cases and bilateral in 11 cases, 10 cases of claudication, associated to bladder
dysfunction in 3 cases. Postural syndrome was observed in 11 cases, spinal
syndrome in 21 and radicular syndrome in 9. A sensory disturbance was found
in 6 cases and a motor disorder in 1 case. Muscle testing at rest and during
exercise performed in 13 patients revealed a muscular deficit in 1 case. X-ray of
the lumbar spine performed in 24 patients showed at least a sign of lumbar
spinal stenosis. The lumbar scan (20 cases) and spinal MRI (3 cases) showed a
constitutional-type in 5 cases, degenerative in 4 cases and mixed in 16 cases.
All patients underwent medical treatment during hospitalization, associated
with infiltration of epidural corticosteroids in 15 cases (12 radio controlled and 3
blind) and rehabilitation sessions 5 to 7 days for an average of 3 weeks. The
program was adapted to each patient. Fourteen patients followed the back
school. Discontinuous traction was indicated for 9 patients, traction of Cotrell
for 1 patient. All patients were given advice on healthy living. Fourteen patients
had lumbar device and 1 a body cast Low back pain disappeared in 20 patients
and radicular pain in 23 patients. Surgery was indicated in 1 case with a good
clinical course.
Discussion-conclusion.– The treatment for lumbar spinal stenosis begins with
conservative treatments. Surgical decision remains the ultimate recourse to
conservative treatment failure and/or worsening of the neurological or of the
bladder status.
http://dx.doi.org/10.1016/j.rehab.2012.07.727
P073-e
Digestive disorders in orthopaedic treatment with brace
cast reduction of spinal deformation: Retrospective study
of 53 cases
M. Bayon-Mottu a,*, M. Dinomais b, G. Gambart c, M.P. Be´ranger b,
J. Palussie`re b, H.F. Parent d, X. Deries b
a Service de me´decine physique et re´adaptation, CHU Poitiers,
2, rue Mile´trie, 86000 Poitiers, France
b C3RF Les Capucins, Angers, France
c CH Saintes, France
d Clinique Saint-Le´onard, Angers, France
*Corresponding author.
E-mail address: marie.bayon@gmail.com.
Keywords: Spinal deformity; Brace cast; Digestive disorders
Introduction.– The orthopaedic treatment of spinal deformity with brace cast is
used from a long time and it has demonstrated its efficiency. Digestive disorders
may occur under this treatment, they are potentially serious such as superior
mesenteric artery (SMAS) or cast syndrome. The frequency of the occurrence
and the importance of these disorders depend on the technique to set-up the
casts. Our methodology consists in initially correct moderately, then thanks to
successive felting during several weeks we obtain the optimum correction.
Objective.– Study the incidence and severity of the digestive disorders when
spinal deformities are treated with brace cast with felts.
Methodology.– Monocentric retrospective study of children treated with brace
cast. The incidence of digestive disorders was listed as: type 1: pain,
constipation, type 2: nausea, vomiting, and type 3: sub-occlusive intestinal
syndrome or incoercible vomiting.
Results.– Fifty-three children were included (girls: 72%). 45% of the children
developed digestive disorders, distributed between 24% of type 1, 17% of type 2
and 4% of type 3 (2 cases). The average time that the symptom begins was 5.74


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Conservative treatment of lumbar radicular pain on lumbar spinal stenosis

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