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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presenta una serie de pacientes diagnosticados en el Hospital Universitario de Canarias &#40;Tenerife&#41; de patolog&#237;a compresiva medular y&#47;o radicular de columna cervical y tratados quir&#250;rgicamente mediante discectom&#237;a cervical por v&#237;a anterior y artrodesis intersom&#225;tica con injerto roscado de Otero&#46; Se analiza un total de 24 niveles intervenidos en 18 pacientes&#44; con un tiempo de evoluci&#243;n postperatorio de 22&#44;6 meses&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El estudio radiol&#243;gico incluy&#243;&#58; 1&#41; la medici&#243;n de la angulaci&#243;n final del nivel operado&#44; 2&#41; el grado de fijaci&#243;n del injerto en las radiograf&#237;as din&#225;micas y 3&#41; su grado de asimilaci&#243;n&#46; Del total de los 24 niveles tratados&#44; 19 consiguieron una buena fijaci&#243;n &#40;79&#46;2 &#37;&#41;&#44; 4 niveles no se fijaron totalmente presentando un rango de movimiento del segmento entre 5&#176; y 7&#176; que no tuvo transcendencia cl&#237;nica &#40;16&#46;7 &#37;&#41;&#44; y en un caso no fue posible visualizar correctamente el interespacio operado&#46; Se estableci&#243; arbitrariamente como angulaci&#243;n en flexi&#243;n una angulacion superior a 3 grados&#46; Seg&#250;n este criterio 20 niveles tuvieron angulaci&#243;n nula &#40;83&#46;3&#37;&#41;&#44; Y 3 casos presentaron una ligera angulaci&#243;n en flexi&#243;n &#40;12&#46;5&#37;&#41;&#46; El grado de asimilaci&#243;n del injerto se clasific&#243; como&#58; claramente asimilado&#44; claramente no asimilado y de asimilaci&#243;n dudosa&#46; En 12 casos se observ&#243; una falta de asimilaci&#243;n &#40;50&#37;&#41;&#44; 7 se asimilaron totalmente &#40;29&#46;2&#37;&#41;&#44; y 4 fueron considerados como dudosos &#40;16&#46;7&#37;&#41;&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se puede concluir que la artrodesis intersom&#225;tica con injerto de Otero&#44; aunque no garantiza completamente ni la fijaci&#243;n absoluta del segmento ni la integraci&#243;n del propio injerto en el lecho vertebral&#44; es eficaz en la mayor&#237;a de los casos&#46;</p>"
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        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A series of patients diagnosed of cervical spondylotic myelopathy were operated upon with discectomy and intersomatic arthrodesis using Otero&#39;s threaded cylindrical bone at the University Hospital of the Canary Islands &#40;Tenerife&#41;&#46; A total of 24 levels&#44; in 18 patients&#44; with a follow-up of 22&#44;6 months&#44; was analysed&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The radiological study included&#58; 1&#41; measurement of the final angulation at the operated level&#44; 2&#41; degree offusion in dinamic cervical radiographies and 3&#41; degree of assimilation of the graft&#46; 19 levels achieved a good fusion &#40;79&#46;2&#37;&#41;&#44; 4 levels didn&#39;t fuse adequately presenting a movement range of 5&#176;&#8211;7&#176; &#40;16&#46;7&#37;&#41;&#59; angulation could not be measured in one case&#46; Pathologic angulation was considered arbitrarily if an anterior angulation of more than 3 degrees was observed&#46; According to that&#44; 20 levels had no angulation &#40;83&#46;3&#37;&#41; and 3 showed slightly angulated in flexion &#40;12&#46;5 &#37;&#41;&#46; The degree of assimilation of the graft was classified as&#58; assimilated&#44; not assimilated&#44; and doubtful assimilation&#46; 12 cases showed no assimilation &#40;50&#37;&#41;&#44;7 cases showed good assimilation &#40;29&#46;2&#37;&#41; and in 4 cases the assimilation was considered as doubtful &#40;16&#46;7&#37;&#41;&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The anterior interbody fusion with Otero&#39;s graft doesn&#39;t guaranty the absolute stability of the segment neither the assimilation&#44; but is effective in the majority of the cases&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Garc&#237;a Pareras&#44; L&#46;&#59; Gonz&#225;lez Feria&#44; L&#46;&#59; Garc&#237;a Mar&#237;n&#44; V&#46;&#58;Artrodesis intersom&#225;tica anterior mediante injerto de Otero&#58; Estudio radiol&#243;gico de la calidad de la artrodesis&#46; Neurocirug&#237;a 1994&#59; 5&#58; 237&#8211;241&#46;</p>"
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Vol. 5. Núm. 3.
Páginas 237-241 (enero 1993)
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Vol. 5. Núm. 3.
Páginas 237-241 (enero 1993)
Artrodesis intersomática anterior mediante injerto de Otero: Estudio radiológico de la calidad de la artrodesis
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1640
L. García Pareras, L. González Feria, V. García Marín
Hospital Universitario de Canarias. Santa Cruz de Tenerife
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Resumen

Se presenta una serie de pacientes diagnosticados en el Hospital Universitario de Canarias (Tenerife) de patología compresiva medular y/o radicular de columna cervical y tratados quirúrgicamente mediante discectomía cervical por vía anterior y artrodesis intersomática con injerto roscado de Otero. Se analiza un total de 24 niveles intervenidos en 18 pacientes, con un tiempo de evolución postperatorio de 22,6 meses.

El estudio radiológico incluyó: 1) la medición de la angulación final del nivel operado, 2) el grado de fijación del injerto en las radiografías dinámicas y 3) su grado de asimilación. Del total de los 24 niveles tratados, 19 consiguieron una buena fijación (79.2 %), 4 niveles no se fijaron totalmente presentando un rango de movimiento del segmento entre 5° y 7° que no tuvo transcendencia clínica (16.7 %), y en un caso no fue posible visualizar correctamente el interespacio operado. Se estableció arbitrariamente como angulación en flexión una angulacion superior a 3 grados. Según este criterio 20 niveles tuvieron angulación nula (83.3%), Y 3 casos presentaron una ligera angulación en flexión (12.5%). El grado de asimilación del injerto se clasificó como: claramente asimilado, claramente no asimilado y de asimilación dudosa. En 12 casos se observó una falta de asimilación (50%), 7 se asimilaron totalmente (29.2%), y 4 fueron considerados como dudosos (16.7%).

Se puede concluir que la artrodesis intersomática con injerto de Otero, aunque no garantiza completamente ni la fijación absoluta del segmento ni la integración del propio injerto en el lecho vertebral, es eficaz en la mayoría de los casos.

Palabras clave:
Discectomía cervical
Fusión cervical intersomática
Injerto roscado
Fusión cervical anterior
Abstract

A series of patients diagnosed of cervical spondylotic myelopathy were operated upon with discectomy and intersomatic arthrodesis using Otero's threaded cylindrical bone at the University Hospital of the Canary Islands (Tenerife). A total of 24 levels, in 18 patients, with a follow-up of 22,6 months, was analysed.

The radiological study included: 1) measurement of the final angulation at the operated level, 2) degree offusion in dinamic cervical radiographies and 3) degree of assimilation of the graft. 19 levels achieved a good fusion (79.2%), 4 levels didn't fuse adequately presenting a movement range of 5°–7° (16.7%); angulation could not be measured in one case. Pathologic angulation was considered arbitrarily if an anterior angulation of more than 3 degrees was observed. According to that, 20 levels had no angulation (83.3%) and 3 showed slightly angulated in flexion (12.5 %). The degree of assimilation of the graft was classified as: assimilated, not assimilated, and doubtful assimilation. 12 cases showed no assimilation (50%),7 cases showed good assimilation (29.2%) and in 4 cases the assimilation was considered as doubtful (16.7%).

The anterior interbody fusion with Otero's graft doesn't guaranty the absolute stability of the segment neither the assimilation, but is effective in the majority of the cases.

Key words:
Cervical discectomy
Cervical interbody fusion
Threaded cylindrical bone graft

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