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Vol. 17. Issue 2.
Pages 132-139 (January 2006)
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Vol. 17. Issue 2.
Pages 132-139 (January 2006)
Artrodesis cervical anterior mediante implante de tantalio. Resultados clínicos y radiológicos
Anterior cervical fusion with tantalum interbody implants. Clinical and radiological results in a prospective study
C. Vicario
, F. Lopez-Oliva, T. Sánchez-Lorente, J.J. Asenjo-Siguero, F. Ladero, A. Ibarzábal
Unidad de columna, Centro de Rehabilitación FREMAP, Majadahonda, Madrid
M. Zimmermann*
* Servicio de Salud Laboral. Instituto de Salud Publica. Comunidad de Madrid
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Resumen

La discectomía cervical anterior con artrodesis intersomática (DCAA) es una técnica quirúrgica ampliamente aceptada en el tratamiento de la enfermedad discal cervical. Recientemente se han introducido con esta indicación las cajas de tantalio debido a sus excelentes propiedades mecánicas y biológicas.

Presentamos los resultados iniciales clínicos y radiológicos de un estudio prospectivo de 24 pacientes intervenidos en nuestro servicio tras el empleo de cajas de tantalio en la DCAA. La evaluación clínica pre y postoperatoria se realizó mediante cuestionario que incluía una Escala Visual Analógica de dolor, el Índice de Oswestry, y la Escala de Zung. Los resultados fueron clasificados mediante los criterios de Odom. La evaluación radiológica incluyó radiografías dinámicas en las que se midieron las variaciones del ángulo de Cobb y la distancia interespinosa. Postoperatoriamente los pacientes fueron revisados en el tercer mes y al año de la intervención.

Todos los parámetros clínicos mejoraron de forma estadísticamente significativa. Según con los criterios de Odom, el 75% de los casos fueron considerados como excelentes o buenos. Sólo se confirmó clínica y radiológicamente un caso de pseudoartrosis. No se observaron diferencias significativas en las revisiones al año y a los 3 meses.

Conclusión

Las cajas de tantalio constituyen un implante prometedor y pensamos que útil entre las diversas opciones quirúrgicas para la DCAA, por sus buenos resultados clínicos, por la no necesidad de autoinjerto, y por su excelente compatibilidad con la resonancia nuclear magnética.

Palabras clave:
Discectomía anterior cervical
Tantalio
Hedrocel
Artrosis cervical
Hernia discal cervical
Abreviaturas:
ACDF
DCAA
EVA
VAS
Summary

Anterior cervical discectomy and interbody fusion (ACDF) is a widely accepted surgical technique in the treatment of cervical disc disease. Tantalum cages have been recently introduced in spine surgery for interbody fusion because of the advantages of their mechanical properties.

We present the results of a prospective clinical and radiological study on 24 consecutive patients who underwent an ACDF with tantalum cages. Clinical evaluation was assessed preoperatively and after surgery by a questionnaire that included a Visual Analogic Scale (VAS) of neck and arm pain, the Oswestry Dissability Index and the Zung Depression Scale. Results were classified by Odom's criteria. Radiological evaluation included flexion-extension X-rays, and changes in distance between spinous processes and Cobb angle were measured. Postoperatively patients were reviewed 3 and 12 months after surgery.

A statisitical significative improvement in all clinical data was reported. According to Odom's criteria in 75% of patients the results were considered like excellent or good. Only one case of radiological and clinical pseudoarthrosis was confirmed. No significative differences were reported 3 and 12 months after surgery.

Tantalum cages are a very promising and usefull alternative among implants available for ACDF. Compatibility with MRI postoperative studies and the unnecessariness of autograft are some of their advantages.

Key words:
Anterior cervical discectomy
Tantalum
Hedrocel
Cervical spondylosis
Cervical disc herniation

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