Journal Information
Vol. 4. Issue 1.
Pages 46-52 (January 1993)
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Vol. 4. Issue 1.
Pages 46-52 (January 1993)
Tratamiento quirúrgico de la mielopatía cervical espondiloartrósica. Estudio preliminar
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M. Clavel Escribano, R. Noboa Baquero, P. Clavel Laria
Servicio de Neurocirugía. Hospital General de Cataluña. Barcelona
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Resumen

Se presenta un estudio clínico preliminar de un grupo de ocho pacientes intervenidos quirúrgicamente de mielopatía cervical espondiloartrósica, con seguimiento que oscila de tres a dieciocho meses. Todos ellos fueron intervenidos con tracción cervical esquelética y en decúbito prono. Extensa laminectomía cervical y foraminotomías con técnica microquirúrgica.

Siguiendo el concepto de que la inmovilización mejora el pronóstico de estos pacientes se añadió un sistema de fusión posterolateral con placas de titanio y tornillos introducidos en las masas articulares (Levtec). Los resultados en este período de seguimiento han sido muy alentadores, pudiéndose realizar estudios de RNM pre y postoperatorios.

Hacemos énfasis en el diagnóstico y cirugía precoz de estos pacientes antes de que las lesiones irreversibles aparezcan. Se discuten otras vías de abordaje para la mielopatía cervical espondiloartrósica.

Palabras clave:
Mielopatía cervical espondiloartrósica
Laminectomía
Fusión vertebral
Summary

This is a preliminary clinical work including the results obtained in eight patients operated on for cervical spondylotic myelopathy with a follow-up of three to eighteen months. They had surgery in prone position under skeletal traction. A large microsurgical cervical laminectomy with foraminotomy was performed.

Following the concept that inmobilization should improve the prognosis in these patients, a posterolateral spinal fusión –with titanium plates and screws introduced in the facets (Levtec)– was added to the procedure. The results are very encouraging and we have performed MRI studies before and after surgery.

We emphasize the importance of an earlier diagnosis and surgical treatment in these patients before they develop irreversible lesions. We discuss alternative approaches for the spondylotic cervical myelopathy.

Key words:
Spondylotic cervical myelopathy
Laminectomy
Vertebral fusion

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