Se presentan doce casos de pacientes con dolor dorsolumbar debido a inestabilidad o lesiones estructurales del raquis y que fueron tratados con un sistema de fijación interna con tornillos pediculares. Las lesiones eran de etiología metastásica (cuatro pacientes), traumática (cuatro pacientes), espodilítica (tres casos) y por inestabilidad postlaminectomía (un caso). Cuatro pacientes presentaban clínica radicular y dos de compresión medular, cinco inestabilidad y siete desviación del raquis. La cirugía transcurrió sin complicaciones y los pacientes mejoraron del dolor y de los déficits neurológicos. Estos resultados permiten recomendar la fijación interna en el tratamiento de lesiones raquídeas inestables o potencialmente inestables que cursan con dolor.
Twelve patients suffering pain due to instability or intrinsic spinal pathology in the thoraco-Iumbar spine were surgically treated with an internal fixation with pedicular screws. The etiology of the lesions was metastasis in four patients, trauma in four, pyogenic spondylitis in three and postlaminectomy instability in one case. Four patients had radicular symptoms and two patients spinal cord compression symptoms. Five patients had spinal instability and seven angulation. Surgery was uneventful. Both pain and neurological deficits disappeared or were ameliorated. These results indicate the value of the internal fixation in the treatment of instable or eventually instable painful spinal lesions.
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