L. Balabaud - Academia.edu (original) (raw)

Papers by L. Balabaud

European Journal of Orthopaedic Surgery & Traumatology, 2001

EMC - Techniques chirurgicales - Orthopédie - Traumatologie, 2011

Revue de Chirurgie Orthopédique et Réparatrice de l'Appareil Moteur, 2004

Annales de Réadaptation et de Médecine Physique, 1997

European Journal of Cancer, 2019

A novel risk calculator to predict outcome after surgery for symptomatic spinal metastases; use o... more A novel risk calculator to predict outcome after surgery for symptomatic spinal metastases; use of a large prospective patient database to personalize surgical management.

EMC - Técnicas Quirúrgicas - Ortopedia y Traumatología, 2012

ABSTRACT La gran mayoría de las indicaciones de la cirugía lumbar corresponden al disco intervert... more ABSTRACT La gran mayoría de las indicaciones de la cirugía lumbar corresponden al disco intervertebral, en especial a la hernia discal lumbar. Sin embargo, esta cirugía debe constituir el último recurso después de un tratamiento médico, salvo complicaciones neurológicas, aunque no existe un consenso sobre las indicaciones. Incluso aunque los resultados se consideran muy buenos, el postoperatorio no siempre es favorable. Las hernias discales pueden tener varias localizaciones: medial, posterolateral, foraminal y extraforaminal. La estrategia quirúrgica debe adaptarse en función de la topografía de la hernia, del antecedente de una recidiva, así como del estado de los platillos vertebrales adyacentes. En este artículo se describe la discectomía por vía posterior medial, la discectomía posterolateral según la técnica de Wiltse, las discectomías endoscópicas transforaminal e interlaminar, así como la cirugía de reintervención discal. Las prótesis lumbares y las artrodesis no se expondrán en este artículo.

Advanced Concepts in Lumbar Degenerative Disk Disease, 2016

Taking into account the various parameters of sagittal spinal imbalance is paramount to treat a s... more Taking into account the various parameters of sagittal spinal imbalance is paramount to treat a symptomatic deformity and restore balance. Pedicle posterior wedge osteotomy is a technically demanding procedure. There are significant potential complications. Pedicle impaction osteotomy may alleviate those complications. Late complications such as nonunion often lead to further challenging surgery.

The Spine Journal, 2015

BACKGROUND Rapidly progressing extrinsic spinal cord compression syndromes are rare, especially w... more BACKGROUND Rapidly progressing extrinsic spinal cord compression syndromes are rare, especially when the compression is associated with the supine position. PURPOSE This work presents a case of extrinsic thoracic spinal cord compression related to the supine position and describes our approach from diagnosis to the technical therapeutic creation of a spinal protection shield. STUDY DESIGN One case of a patient suffering from extrinsic spinal cord compression syndrome is reported. PATIENT SAMPLE We report the case of a Coptic priest patient who, as a result of Pott disease sequelae, underwent several decompressive and stabilizing surgeries for major kyphoscoliosis. Consequently, he developed extrinsic thoracic spinal cord compression caused by the supine position. OUTCOME MEASURES After each instrumentation device removal, we noticed progressive severe paraparesis when the patient was supine. Imaging assessment confirmed spinal dynamic and intermittent compressions triggered by the supine position, which was facilitated by the exposure and vulnerability of the thoracic spine cord. METHODS We implanted a tailored titanium mesh spinal protection shield and a trapezius flap for spine coverage. This work presents the diagnostic aspects as well as several surgical technique options. RESULTS At the 6-year follow-up, the patient's neurologic conditions were significantly improved. We report neurologic improvements, no sphincter disorder, persistent spasticity, and lower limbs weakness not affecting full ambulation. CONCLUSIONS To our knowledge, no other case of spinal protection shield in compressions caused by the supine position have been studied. The surgical and technical management therefore remains innovative.

Revue de Chirurgie Orthopédique et Traumatologique, 2011

ArgoSpine News & Journal, 2011

Alternatives à l'arthrodèse lombaire et lombosacrée, 2007

EMC - Tecniche Chirurgiche - Chirurgia Ortopedica, 2012

ABSTRACT La grande maggioranza delle indicazioni alla chirurgia lombare interessa il disco interv... more ABSTRACT La grande maggioranza delle indicazioni alla chirurgia lombare interessa il disco intervertebrale, in particolare l’ernia discale lombare. Tuttavia, questa chirurgia deve costituire l’ultima risorsa dopo un trattamento medico, salvo complicazioni neurologiche, anche se non vi è consenso sulle indicazioni. In effetti, anche se i risultati sono considerati molto buoni, le sequele operatorie non sempre sono favorevoli. Le ernie discali possono avere diverse localizzazioni: mediana, posterolaterale, intraforaminale ed extraforaminale. La strategia chirurgica deve essere adattata in funzione della topografia dell’ernia, dell’eventuale recidiva, dello stato del disco e dei piatti vertebrali adiacenti. Questo articolo tratta la discectomia per via posteriore mediana, la discectomia posterolaterale secondo Wiltse, le discectomie endoscopiche transforaminale e interlaminare, e la chirurgia di revisione discale. Le protesi lombari e le artrodesi non sono trattate in questo articolo.

$Research paper thumbnail of Instabilité fémoro-patellaire douloureuse consécutive à une fracture patellaire peropératoire durant le prélèvement d’un greffon os-tendon-os de reconstruction du ligament croisé antérieur$

Revue de Chirurgie Orthopédique et Traumatologique, 2012

ABSTRACT La reconstruction du ligament croisé antérieur (LCA) du patient jeune et actif est une c... more ABSTRACT La reconstruction du ligament croisé antérieur (LCA) du patient jeune et actif est une chirurgie routinière dont il convient de connaître les risques. La fracture périopératoire de patella après prélèvement d’un greffon os-tendon patellaire-os est une complication rare, qui peut altérer sérieusement le résultat fonctionnel final de la reconstruction du pivot central. Nous rapportons ici le cas d’une patiente présentant un syndrome fémoro-patellaire handicapant à trois ans d’une reconstruction du LCA par autogreffe os-tendon-os sous arthroscopie, en rapport avec un cal vicieux patellaire sur fracture sagittale peropératoire passée inaperçue. Nous présentons ici une prise en charge chirurgicale par ostéotomie patellaire ayant permis de corriger l’instabilité patellaire douloureuse iatrogène.

$Research paper thumbnail of Painful patellofemoral instability secondary to peroperative patellar fracture during bone-patellar tendon-bone autograft harvesting for anterior cruciate ligament reconstruction$

Orthopaedics & Traumatology: Surgery & Research, 2012

Reconstructive surgery of the anterior cruciate ligament (ACL) of the knee in young active patien... more Reconstructive surgery of the anterior cruciate ligament (ACL) of the knee in young active patients is a routine procedure, but with certain risks that need to be taken into account. Peroperative patellar fracture after bone-patellar tendon-bone autograft harvesting is a rare complication, which can significantly impair the functional outcome of ACL single-bundle reconstruction. We report the case of a patient presenting with disabling patellofemoral syndrome 3 years after arthroscopic ACL reconstruction by bone-tendon-bone autograft, revealing unnoticed mal-union of a iatrogenic sagittal patellar fracture. Patellar osteotomy corrected this painful iatrogenic patellar instability.

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, Jan 30, 2014

The life expectancy increased significantly during last four decades and is associated with an in... more The life expectancy increased significantly during last four decades and is associated with an increasing quality of life. The purpose of this study was to determine morbidity and mortality of degenerative lumbar spine surgery in patients 80 years of age or older. A consecutive retrospective review evaluated 121 consecutive patients, who had undergone posterior decompression associated or not with lumbar instrumentation. The average age at the time of surgery was 83.2 ± 2.4 years. The study analyzed the comorbidities, the operative procedure and postoperative morbidity and mortality. Blood loss increased significantly with instrumentation (538 vs. 280 mL, p < 0.0001). The average operative time was 103 ± 38 min and increased significantly with instrumentation (131.2 vs. 84 min, p = 0.003), blood loss (p < 0.0001) and dural tears (p = 0.05). Dural tears occurred in 19 patients (15.7 %) and were associated significantly with previous lumbar surgery (33.3 vs. 12.4 %, p = 0.017) a...

ArgoSpine News & Journal, 2012

Revue de Chirurgie Orthopédique et Traumatologique, 2014

Resume Objectif Evaluer les resultats en termes de qualite de vie chez les patients subissant une... more Resume Objectif Evaluer les resultats en termes de qualite de vie chez les patients subissant une chirurgie curative extensive pour tumeur rachidienne et les comparer a la population francaise generale. Introduction L’esperance de vie n’est pas le seul critere de resultat apres des resections tumorales massives. La qualite de vie residuelle est egalement cruciale. L’indication de chirurgie majeure pour tumeur rachidienne doit prendre en compte le statut fonctionnel a long terme du patient, or seule une litterature limitee se penche sur la question. Patients et methodes Vingt-cinq patients vivants issus d’un groupe de 120 operes ont ete evalues. Tous furent operes par le meme chirurgien entre 1984 et 2007. Le suivi moyen est de 9 ans (intervalle : de 3 a 25 ans). L’âge moyen a l’operation etait de 49 ans. Les patients ont complete differents questionnaires fonctionnels et de qualite de vie : Oswestry Disability Index version 2 (ODI), Prolo, Karnofsky Index of Performance Status (KI), Eastern Cooperative Oncology Group Performance Status (ECOG), Short Form-36 Health Survey (SF-36) et EuroQoL-5 Dimensions (EQ5D). De plus, chaque patient a ete evalue cliniquement et radiographiquement. Des sous-groupes ont ete identifies en considerant le nombre de niveaux reseques et l’histologie. Leurs resultats au SF-36 ont ete compares avec ceux de la population generale francaise. Resultats En moyenne, le PCS (composante physique du SF-36) etait a 52,4, le MCS (composante psychique du SF-36) a 47,7, l’ODI a 18,2, le Prolo a 7, l’ECOG a 1 et le KI a 80 %. Les resections de trois niveaux sont associees aux moins bons resultats de qualite de vie mais, dans l’ensemble, les resultats etaient similaires aux donnees de la population generale francaise pour toutes les categories du SF-36. Conclusion Les indications appropriees de resection rachidienne massive donnent de bons resultats oncologiques et fonctionnels. Si c’est l’esperance de vie attendue qui justifie cette chirurgie agressive, la qualite de vie postoperatoire montre qu’elle peut egalement constituer un succes sur le plan fonctionnel. Niveau de preuve Niveau IV, etude clinique retrospective.

Orthopaedics & Traumatology: Surgery & Research, 2014

Objective: Assess quality-of-life results in patients who have undergone extensive curative surge... more Objective: Assess quality-of-life results in patients who have undergone extensive curative surgery for spinal tumor and compare them to the general population in France. Introduction: Life expectancy is not the only criterion to assess the outcomes after massive tumor resections. Residual quality of life is also crucial. An indication for major surgery for spinal tumor should take the patient's long-term functional status into account, but the literature is limited on this question. Materials and methods: Twenty-five living patients from a group of 120 operated were assessed, all of whom were operated on by the same surgeon between 1984 and 2007. The mean follow-up was 9 years (range, 3-25 years). The mean age at surgery was 49 years. The patients completed different functional and quality-of-life questionnaires: the Oswestry Disability Index version 2 (ODI), the PROLO, the Karnofsky Index of performance status (KI), the Eastern Cooperative Oncology Group performance status (ECOG), the Short Form-36 Health Survey (SF-36), and the EuroQol-5 Dimensions (EQ5D). In addition, each patient was clinically and radiographically evaluated. Subgroups were identified considering the number of levels resected and histology. Their results on the SF-36 were compared with the results from the general population in France. Results: The mean PCS (physical component summary of the SF-36) was 52.4, the MCS (mental component summary, the psychological component of the SF-36) was 47.7, the ODI was 18.2, the PROLO was 7, the ECOG was 1, and the KI was 80%. The resections at three levels were associated with worse results in terms of quality of life, but overall, the results were similar to the French general population data for all categories of the SF-36. Conclusion: Appropriate indications for massive spinal resection give good oncological and functional results. Although the expected life expectancy justifies this aggressive surgery, postoperative quality of life shows that it can also be successful on a functional level. Level of evidence: Level IV; retrospective clinical study.