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Ciencia y tecnología

Licencia de YouTube estándar

#columna cervical subaxial #columna cervical #lesiones

lunes, 26 de junio de 2017

Eficacia de la cirugía temprana para la mejora neurológica en la lesión de la médula espinal sin evidencia radiográfica de trauma en los ancianos.

http://www.columnavertebralpediatricaygeriatrica.com.mx/academia/eficacia-de-la-cirugia-temprana-para-la-mejora-neurologica-en-la-lesion-de-la-medula-espinal-sin-evidencia-radiografica-de-trauma-en-los-ancianos/

Efficacy of early surgery for neurological improvement in spinal cord injury without radiographic evidence of trauma in the elderly.

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28645598

http://www.worldneurosurgery.org/article/S1878-8750(17)30962-2/pdf

De:

Inoue T1,Suzuki S2,Endo T3,Uenohara H2,Tominaga T4.

World Neurosurg.

2017 Jun 20. pii: S1878-8750(17)30962-2. doi: 10.1016/j.wneu.2017.06.070. [Epub ahead of print]

Copyright © 2017 Elsevier Inc. All rights reserved.

Abstract

OBJECT:

The optimal timing for surgery for patients with spinal cord injury without radiographic evidence of trauma (SCIWORET) remains unclear. This is especially true in the elderly, because most studies are done with younger patients to avoid age-related comorbidities. We therefore aimed to compare the efficacy of early (less than 24 hours post-injury) versus late (more than 24 hours post-injury) surgery in patients with SCIWORET aged 65 years or older.

CONCLUSIONS:

The present study indicated that early surgery within 24 hours of injury for elderly patients with SCIWORET could lead to more favorable neurological improvements. We believe that chronological age alone should not be considered sufficient justification to deny patients early surgical decompression for SCIWORET.

KEYWORDS:

JOA score; SCIWORET; degenerative cervical spine disorders; early surgery; elderly

Resumen

OBJETO:
El momento óptimo para la cirugía para pacientes con lesión de la médula espinal sin evidencia radiográfica de trauma (SCIWORET) sigue siendo poco claro. Esto es especialmente cierto en los ancianos, porque la mayoría de los estudios se realizan con pacientes más jóvenes para evitar las comorbilidades relacionadas con la edad. Por lo tanto, se intentó comparar la eficacia de la cirugía temprana (menos de 24 horas después de la lesión) versus tardía (más de 24 horas después de la lesión) en pacientes con SCIWORET de 65 años o más.

CONCLUSIONES:
El presente estudio indicó que la cirugía temprana dentro de las 24 horas de la lesión en pacientes ancianos con SCIWORET podría conducir a mejoras neurológicas más favorables. Creemos que la edad cronológica por sí sola no debe considerarse una justificación suficiente para negar a los pacientes la descompresión quirúrgica temprana para SCIWORET.

PALABRAS CLAVE:
Puntuación JOA; SCIWORET; Trastornos degenerativos de la columna cervical; Cirugía temprana; anciano

PMID: 28645598 DOI:

10.1016/j.wneu.2017.06.070

#SCIWORET #Trastornos degenerativos #columna cervical #Cirugía temprana #anciano

miércoles, 29 de marzo de 2017

Anatomía de la columna cervical posterior

http://www.columnavertebralpediatricaygeriatrica.com.mx/academia/anatomia-de-la-columna-cervical-posterior/

Anatomy of the Posterior Cervical Spine

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/cCVFxSpOoW8

Courtesy: Seattle Science Foundation

www.seattlesciencefoundation.org

http://www.seattlesciencefoundation.org

Categoría
Licencia

Ciencia y tecnología

Licencia de YouTube estándar

#anatomía #columna cervical

viernes, 24 de marzo de 2017

La efectividad de la terapia manual versus la cirugía de la función autoinformada, la amplitud de movimiento cervical y la fuerza de sujeción de la pinza en el síndrome del túnel carpiano: un ensayo clínico aleatorizado

http://www.medicina-rehabilitacion.com/medicina-fisica/la-efectividad-de-la-terapia-manual-versus-la-cirugia-de-la-funcion-autoinformada-la-amplitud-de-movimiento-cervical-y-la-fuerza-de-sujecion-de-la-pinza-en-el-sindrome-del-tunel-carpiano-un-ensayo-c/

The Effectiveness of Manual Therapy Versus Surgery on Self-reported Function, Cervical Range of Motion, and Pinch Grip Force in Carpal Tunnel Syndrome: A Randomized Clinical Trial

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28158963

http://www.jospt.org/doi/10.2519/jospt.2017.7090?code=jospt-site

De:

Fernández-de-Las-Peñas C, Cleland J, Palacios-Ceña M, Fuensalida-Novo S, Pareja JA, Alonso-Blanco C.

J Orthop Sports Phys Ther. 2017 Mar;47(3):151-161. doi: 10.2519/jospt.2017.7090. Epub 2017 Feb 3.

Abstract
Study Design Randomized parallel-group trial. Background Carpal tunnel syndrome (CTS) is a common pain condition that can be managed surgically or conservatively. Objective To compare the effectiveness of manual therapy versus surgery for improving self-reported function, cervical range of motion, and pinch-tip grip force in women with CTS

Conclusion Manual therapy and surgery had similar effectiveness for improving self-reported function, symptom severity, and pinch-tip grip force on the symptomatic hand in women with CTS. Neither manual therapy nor surgery resulted in changes in cervical range of motion.

Level of Evidence Therapy, level 1b. Prospectively registered September 3, 2014 at www.clinicaltrials.gov (NCT02233660). J Orthop Sports Phys Ther 2017;47(3):151-161. Epub 3 Feb 2017. doi:10.2519/jospt.2017.7090.

KEYWORDS:

carpal tunnel syndrome; cervical spine; force; manual therapy; neck; surgery

PMID: 28158963 DOI: 10.2519/jospt.2017.7090

Resumen

Diseño del estudio Ensayo aleatorio de grupos paralelos. Antecedentes El síndrome del túnel carpiano (CTS) es una condición de dolor común que se puede manejar quirúrgicamente o conservadoramente. Objetivo Comparar la efectividad de la terapia manual versus la cirugía para mejorar la función autoinformada, la amplitud del movimiento cervical y la fuerza de agarre con pinch-tip en mujeres con CTS
Conclusión La terapia y la cirugía manuales tuvieron una eficacia similar para mejorar la función autoinformada, la gravedad de los síntomas y la fuerza de agarre con pinch-tip en la mano sintomática en mujeres con CTS. Ni la terapia manual ni la cirugía resultaron en cambios en el rango de movimiento cervical.
PALABRAS CLAVE:
síndrome del túnel carpiano; columna cervical; fuerza; terapia manual; cuello; cirugía

Etiquetas: cirugía, columna cervical, cuello, fuerza, síndrome del túnel carpiano, terapia manual

sábado, 11 de marzo de 2017

La artritis reumatoide en la columna cervical

http://www.ortopediaycolumna.com.mx/columna/la-artritis-reumatoide-en-la-columna-cervical/

Cervical Spine in Rheumatoid Arthritis

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/t-NNF5IHJfI

Courtesy: Prof Nabil Ebraheim,

University of Toledo, Ohio, USA

Dr. Ebraheim educational animated video illustrates spine concepts associated the cervical spine – rheumatoid arthritis.
Cervical spine involvement occurs in about 90% of the patients with rheumatoid arthritis.
All rheumatoid arthritis patients should have cervical spine examination.
Start with getting cervical spine x-rays, because this helps to diagnose atlantoaxial instability.
Early aggressive medical treatment can decrease this risk.
C1-C2 instability is common and can occur in up to 80%.
It occurs due to transverse ligament pathology.
So you will need to get flexion extension views in patients with rheumatoid arthritis, especially preoperative x-rays, and if it looks bad, you have to stabilize the spine before doing elective total hip or total knee procedures.
Discover the C1-C2 instability and fix it first before doing elective total hip procedure.
You see in the x-rays the Atlanto Dental Interval: A.D.I., if it was more than 3.5 mm that means instability of the upper cervical spine may be present.
If it is more than 7 mm it means disruption of the alar ligament, these patients can have cervical spine myelopathy.
The A.D.I. is an unreliable predictor of paralysis.
The posterior atlanto dental interval is a better predicting test, it can predict the spinal cord injury better.
If the posterior A.D.I. is less than 14 mm it can predict spinal cord injury, get an MRI.
The surgery is done if the A.D.I. is more than 10mm or if the P.A.D.I. is less than 14mm, the operation is C1-C2 fusion.
Clinically: the C1-C2 instability could give neck pain, headache, and myelopathy with abnormal gait, paresthesia and difficulty in fine motor control.
Basilar Invagination:
Occur in about 40% of the patients with rheumatoid arthritis, basilar invagination is superior migration of the odontoid so the tip of the odontoid is above the foramen magnum; in this case you do occiput to C2 fusion, plus or minus odontoid resection.
The Subaxial Subluxation:
Occur in about 20% of the patients.
Indication of surgery is neurological compromise.
The space available for the cord is less than 14 mm then do posterior fusion surgery; surgery is usually not successful in severe types of neurological impairment.
When do you do surgery in rheumatoid arthritis?
You do it if there is:
• Severe pain
• Neurological deficit
• X-ray showing that the P.A.D.I. is less than 14mm
• Superior odontoid migration
• Subaxial subluxation and the sagittal canal diameter is less than 14 mm.
If the posterior atlanto- dental interval (P.A.D.I.) is more than 14 mm, the patient will demonstrate significant motor recovery after surgery.

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