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Vol. 7. Issue 1.
Pages 4-10 (January 1996)
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Vol. 7. Issue 1.
Pages 4-10 (January 1996)
Tratamiento quirúrgico de la mielopatía cervical espondiloartrósica
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M. Clavel Escribano, P. Clavel Laria
Servicio de Neurocirugía, Hospital General de Cataluña, Barcelona
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Resumen

Se presentan los resultados de una serie de 21 pacientes consecutivos intervenidos quirúrgicamente de mielopatía espondilótica o espondiloartrósica. Catorce de ellos fueron intervenidos por vía posterior con extensa laminectomía cervical y fijación interna con placas de titanio y tornillos introducidos en las masas articulares.

Los otros 7 pacientes fueron intervenidos por vía anterior (corpectomía a uno o múltiples niveles) con injerto autólogo y fijación interna con placa y tornillos.

Se insiste en la conveniencia de relacionar los estudios radiológicos con la clínica de los pacientes para evitar los diagnósticos erróneos. Hacemos énfasis en la necesidad prioritaria de realizar una descompresión adecuada tanto por vía anterior como posterior. Se establece la conveniencia de adoptar una u otra vía dependiendo cual sea la localización preferente de la compresión, desaconsejando la vía posterior en los enfermos con deformidad cifótica de la columna cervical.

Insistimos en intervenir a estos pacientes en una fase más precoz, antes de que las lesiones mielomalácicas sean evidentes en los estudios de resonancia magnética.

Palabras Clave:
Mielopatía cervical espondiloartrósica
Larninectomía
Fusión vertebral
Summary

We are reporting our results with 21 consecutive patients treated surgically of cervical spondylotic myelopathy. In 14 of them we performed cervical laminectomy in addition to a posterolateral fusion with titanium plates and screws introduced in the lateral masses.

The other 7 patients were treated with an anterior approach, corpectomy at single or multiple levels, placement of autologous graft and fixation with plates and screws.

It is important to correlate the radiological findings with the clinical symptomatology to avoid misdiagnosis. We emphasize the priority of adquate descompression with anterior and posterior approach. The decision to perform one or the other depends on where the compression is located. We should avoid posterior decompression in the presence of a kyphotic deformity.

We emphasize the importance of an earlier diagnosis and surgical treatment before they develop irreversible lesions.

Key Words:
Spondylotic cervical myelopathy
Laminectomy
Vertebral fusion

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