Implantes Interespinosos: son los nuevos implantes mejor que la última generación? Una revisión

http://www.cirugiavertebral.com.mx/academia/implantes-interespinosos-son-los-nuevos-implantes-mejor-que-la-ultima-generacion-una-revision/


Interspinous implants: are the new implants better than the last generation? A review


Fuente

Este artículo es originalmente publicado en:


https://www.ncbi.nlm.nih.gov/pubmed/28332140


https://link.springer.com/article/10.1007%2Fs12178-017-9401-z


De:


Pintauro M1,Duffy A1,Vahedi P2,3,Rymarczuk G1,4,Heller J1.


Curr Rev Musculoskelet Med.


2017 Mar 22. doi: 10.1007/s12178-017-9401-z. [Epub ahead of print]


Todos los derechos reservados para:


© Springer Science+Business Media New York 2017


Abstract


PURPOSE OF REVIEW:


Interspinous process devices (IPDs) are used in the surgical treatment of lumbar spinal stenosis. The purpose of this review is to compare the first generation with the next-generation devices in terms of complications, device failure, reoperation rates, symptom relief, and outcome.


RECENT FINDINGS:


Thirty-seven studies were included from 2011 to 2016. Device failure occurred at a mean of 3.7%, with a lower tendency to happen with next-generation IPDs. Reoperations occurred at a lower rate with the next-generation devices, with a mean follow up of 24 months (3.7% vs. 11.1%). The clinical outcome is not influenced by the type of IPD. The long-term functionality of these devices is questionable, with radiologic changes and recurrence of symptoms often seen by 2 years following implantation. Next-generation devices do not appear to be subject to the same “bounce back” effect of symptom re-emergence after several years.


KEYWORDS:


Canal stenosis; Coflex; Interspinous device; Lumbar; Spine; X-Stop


Resumen





OBJETIVO DE LA REVISIÓN:

En el tratamiento quirúrgico de la estenosis espinal lumbar se utilizan dispositivos de proceso interespinoso (IPD). El propósito de esta revisión es comparar la primera generación con los dispositivos de próxima generación en términos de complicaciones, fallo del dispositivo, tasas de reoperación, alivio de los síntomas y resultado.





RESULTADOS RECIENTES:

Treinta y siete estudios se incluyeron de 2011 a 2016. El fallo del dispositivo se produjo en una media del 3,7%, con una menor tendencia a ocurrir con IPDs de próxima generación. Las reopera- ciones se produjeron a un ritmo menor con los dispositivos de próxima generación, con un seguimiento medio de 24 meses (3,7% frente a 11,1%). El resultado clínico no está influenciado por el tipo de IPD. La funcionalidad a largo plazo de estos dispositivos es cuestionable, con cambios radiológicos y la recurrencia de los síntomas a menudo visto en 2 años después de la implantación. Los dispositivos de la próxima generación no parecen estar sujetos al mismo efecto de “rebote” del resurgimiento de los síntomas después de varios años.





PALABRAS CLAVE:

Conducto lumbar estrecho; Coflex; Dispositivo interespinoso; Lumbar; columna; X-Stop


PMID: 28332140 DOI:


10.1007/s12178-017-9401-z



#conducto lumbar estrecho #coflex #columna

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.

Todos los derechos reservados para:

©2017 Journal of Orthopaedic & Sports Physical Therapy

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

El anciano quirúrgico / Suigical elderly patients

Marzo 21, 2017. No. 2635

Los pacientes geriátricos tienen más posibilidades de complicaciones perioperatorias, incluyendo la muerte. La fragilidad y las fallas orgánicas son factores de riesgo que se deben de conocer y cuantificar detenidamente durante la evaluación preanestésica. Esta semana le enviaremos información sobre este tema. Geriatric patients are more likely to have perioperative complications, including death. Fragility and organic failure are risk factors that must be known and quantified carefully during the preanesthetic evaluation. This week we will send you information on this subject. Pacientes geriátricos são mais propensos a complicações perioperatórias, incluindo a morte. Fragilidade e falência de órgãos são factores de risco que devem ser cumpridas e cuidadosamente quantificados durante a avaliação pré-anestésica. Nesta semana, vamos enviar-lhe informações sobre este tópico. Evaluación preoperatoria del paciente quirúrgico de mayor edad: Sobre los síndromes geriátricos. Preoperative assessment of the older surgical patient: honing in on geriatric syndromes. Kim S1, Brooks AK2, Groban L2. Clin Interv Aging. 2014 Dec 16;10:13-27. doi: 10.2147/CIA.S75285. eCollection 2015Abstract Nearly 50% of Americans will have an operation after the age of 65 years. Traditional preoperative anesthesia consultations capture only some of the information needed to identify older patients (defined as ≥65 years of age) undergoing elective surgery who are at increased risk for postoperative complications, prolonged hospital stays, and delayed or hampered functional recovery. As a catalyst to this review, we compared traditional risk scores (eg, cardiac-focused) to geriatric-specific risk measures from two older female patients seen in our preoperative clinic who were scheduled for elective, robotic-assisted hysterectomies. Despite having a lower cardiac risk index and Charlson comorbidity score, the younger of the two patients presented with more subtle negative geriatric-specific risk predictors - including intermediate or pre-frail status, borderline malnutrition, and reduced functional/mobility - which may have contributed to her 1-day-longer length of stay and need for readmission. Adequate screening of physiologic and cognitive reserves in older patients scheduled for surgery could identify at-risk, vulnerable elders and enable proactive perioperative management strategies (eg, strength, balance, and mobility prehabilitation) to reduce adverse postoperative outcomes and readmissions. Here, we describe our initial two cases and review the stress response to surgery and the impact of advanced age on this response as well as preoperative geriatric assessments, including frailty, nutrition, physical function, cognition, and mood state tests that may better predict postoperative outcomes in older adults. A brief overview of the literature on anesthetic techniques that may influence geriatric-related syndromes is also presented. KEYWORDS: frailty; mobility-disability; postoperative delirium; preoperative evaluation; stress response PDF Mortalidad prevenible después de cirugía urológica común. ¿Fallar en el rescate? Preventable mortality after common urological surgery: failing to rescue? Sammon JD1, Pucheril D, Abdollah F, Varda B, Sood A, Bhojani N, Chang SL, Kim SP, Ruhotina N, Schmid M, Sun M, Kibel AS, Menon M, Semel ME, Trinh QD. BJU Int. 2015 Apr;115(4):666-74. doi: 10.1111/bju.12833. Epub 2014 Aug 19. Abstract OBJECTIVE: To assess in-hospital mortality in patients undergoing many commonly performed urological surgeries in light of decreasing nationwide perioperative mortality over the past decade. This phenomenon has been attributed in part to a decline in 'failure to rescue' (FTR) rates, e.g. death after a complication that was potentially recognisable/preventable. PATIENTS AND METHODS: Discharges of all patients undergoing urological surgery between 1998 and 2010 were extracted from the Nationwide Inpatient Sample and assessed for overall and FTR mortality. Admission trends were assessed with linear regression. Logistic regression models fitted with generalised estimating equations were used to estimate the impact of primary predictors on over-all and FTR mortality and changes in mortality rates. RESULTS: Between 1998 and 2010, an estimated 7,725,736 urological surgeries requiring hospitalisation were performed in the USA; admissions for urological surgery decreased 0.63% per year (P = 0.008). Odds of overall mortality decreased slightly (odds ratio [OR] 0.990, 95% confidence interval [CI] 0.988-0.993), yet the odds of mortality attributable to FTR increased 5% every year (OR 1.050, 95% CI 1.038-1.062). Patient age, race, Charlson Comorbidity Index, public insurance status, as well as urban hospital location were independent predictors of FTR mortality (P < 0.001). CONCLUSION: A shift from inpatient to outpatient surgery for commonly performed urological procedures has coincided with increasing rates of FTR mortality. Older, sicker, minority group patients and those with public insurance were more likely to die after a potentially recognisable/preventable complication. These strata of high-risk individuals represent ideal targets for process improvement initiatives. KEYWORDS: failure to rescue; preventable mortality; urological surgery PDF Curso sobre Anestesia en Trasplantes, Cirugía abdominal, Plástica, Oftalmología y Otorrinolaringología. Committee for European Education in Anaesthesiology (CEEA)  y el Colegio de Anestesiólogos de León A.C. Abril 7-9, 2017, León Guanajuato, México Informes  (477) 716 06 16, kikinhedz@gmail.com Congreso Latinoamericano de Anestesia Regional Asociación Latinoamericana de Anestesia Regional, Capítulo México Ciudad de México, Mayo 24-27, 2017 Informes http://r.enviosgrupolahe.com/2e7l0th0feu87f.html  Vacante para Anestesiología Pediátrica Hospital de Especialidades Pediátrico de León, Guanajuato  México  Informes con la Dra Angélica García Álvarez  angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

TÉCNICA QUIRÚRGICA Y RESULTADOS CLÍNICOS DE LA TRANSFERENCIA OSTEOCONDRAL RETRÓGRADA DE AUTOINJERTO PARA LESIONES OSTEOCONDRALES DE LA MESETA TIBIAL

http://www.perezartro.com.mx/academia/tecnica-quirurgica-y-resultados-clinicos-de-la-transferencia-osteocondral-retrograda-de-autoinjerto-para-lesiones-osteocondrales-de-la-meseta-tibial/

Surgical Technique and Clinical Outcomes of Retrograde Osteochondral Autograft Transfer for Osteochondral Lesions of the Tibial Plateau

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28325693

http://www.arthroscopyjournal.org/article/S0749-8063(17)30100-7/abstract

De:

Yabumoto H1,Nakagawa Y2,Mukai S2,Saji T2,Nakamura T2.

Arthroscopy.

2017 Mar 18. pii: S0749-8063(17)30100-7. doi: 10.1016/j.arthro.2017.01.026. [Epub ahead of print]

Todos los derechos reservados para:

Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Abstract

PURPOSE:

To present the surgical technique, clinical outcomes, and poor prognostic factors of arthroscopic retrograde osteochondral autograft transfer of the tibial plateau.

CONCLUSIONS:

Most clinical scores improved significantly postoperatively. The results indicate that arthroscopic retrograde osteochondral autograft transfer is an effective procedure to achieve sufficient cartilage congruity for osteochondral lesions of the tibial plateau <400 mm² in size.

Resumen

PROPÓSITO:

Presentar la técnica quirúrgica, los resultados clínicos y los malos factores pronósticos de la transferencia artroscópica retrógrada osteocondral del autoinjerto de la meseta tibial.

CONCLUSIONES:

La mayoría de las puntuaciones clínicas mejoraron significativamente en el postoperatorio. Los resultados indican que la transferencia artroscópica retrógrada osteocondral de autoinjerto es un procedimiento eficaz para lograr una congruencia suficiente del cartílago para las lesiones osteocondrales de la meseta tibial <400 mm2 de tamaño.

Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

PMID:   28325693   DOI:  

10.1016/j.arthro.2017.01.026

#Técnica quirúrgica#RESULTADOS CLÍNICOS#TRANSFERENCIA OSTEOCONDRAL RETRÓGRADA#lesiones osteocondrales#meseta tibial