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array:23 [ "pii" => "S1130147304704406" "issn" => "11301473" "doi" => "10.1016/S1130-1473(04)70440-6" "estado" => "S300" "fechaPublicacion" => "2004-01-01" "aid" => "70440" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "2004" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2004;15:543-51" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4354 "formatos" => array:3 [ "EPUB" => 24 "HTML" => 1455 "PDF" => 2875 ] ] "itemSiguiente" => array:18 [ "pii" => "S1130147304704418" "issn" => "11301473" "doi" => "10.1016/S1130-1473(04)70441-8" "estado" => "S300" "fechaPublicacion" => "2004-01-01" "aid" => "70441" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Neurocirugia. 2004;15:551-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1777 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 991 "PDF" => 769 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Comentario al trabajo: <span class="elsevierStyleItalic">Empiema epidural espinal. Análisis de 14 casos</span> de M. Gelabert-González y cols" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "551" "paginaFinal" => "552" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Gregorio R. Boto" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Gregorio R." "apellidos" => "Boto" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704418?idApp=UINPBA00004B" "url" => "/11301473/0000001500000006/v1_201305151229/S1130147304704418/v1_201305151229/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S113014730470439X" "issn" => "11301473" "doi" => "10.1016/S1130-1473(04)70439-X" "estado" => "S300" "fechaPublicacion" => "2004-01-01" "aid" => "70439" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2004;15:525-42" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3568 "formatos" => array:3 [ "EPUB" => 22 "HTML" => 1278 "PDF" => 2268 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Meningiomas of the basal posterior fossa. Surgical experience in 80 cases" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "525" "paginaFinal" => "542" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Meningiomas basales de la fosa posterior. Experiencia quirúrgica con 80 casos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R.D. Lobato, P. González, R. Alday, A. Ramos, A. Lagares, J.F. Alen, J.C. Palomino, P. Miranda, A. Perez-Nuñez, I. Arrese" "autores" => array:10 [ 0 => array:2 [ "nombre" => "R.D." "apellidos" => "Lobato" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "González" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Alday" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Ramos" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Lagares" ] 5 => array:2 [ "nombre" => "J.F." "apellidos" => "Alen" ] 6 => array:2 [ "nombre" => "J.C." "apellidos" => "Palomino" ] 7 => array:2 [ "nombre" => "P." "apellidos" => "Miranda" ] 8 => array:2 [ "nombre" => "A." "apellidos" => "Perez-Nuñez" ] 9 => array:2 [ "nombre" => "I." "apellidos" => "Arrese" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014730470439X?idApp=UINPBA00004B" "url" => "/11301473/0000001500000006/v1_201305151229/S113014730470439X/v1_201305151229/en/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Empiema epidural espinal. Análisis de 14 casos" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "543" "paginaFinal" => "551" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Gelabert-González, J. González-García, J.M. Fernández-Villa, A. GarcíaAllut, R. Martínez-Rumbo" "autores" => array:5 [ 0 => array:3 [ "nombre" => "M." "apellidos" => "Gelabert-González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "González-García" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Fernández-Villa" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "GarcíaAllut" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Martínez-Rumbo" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital Clínico Universitario de Santiago. Departamento de Cirugía. Universidad de Santiago de Compostela" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de neurocirugía Hospital Clínico. La Choupana s/n. 15706 Santiago de Compostela." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Spinal epidural empyema. Analysis of 14 cases" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-03-30" "fechaAceptado" => "2004-04-27" "PalabrasClave" => array:2 [ "es" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158608" "palabras" => array:5 [ 0 => "Absceso epidural espinal" 1 => "Empiema epidural espinal" 2 => "Laminectomía" 3 => "Infección espinal" 4 => "Resonancia magnética" ] ] 1 => array:4 [ "clase" => "abr" "titulo" => "Abreviaturas" "identificador" => "xpalclavsec158609" "palabras" => array:3 [ 0 => "EEE" 1 => "PCR" 2 => "VSG" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158610" "palabras" => array:5 [ 0 => "Laminectomy" 1 => "Magnetic resonance imaging" 2 => "Spinal epidural abscess" 3 => "Spinal epidural empyema" 4 => "Spinal infection" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Realizar un estudio sobre los casos de empiema epidural espinal atendidos en los últimos 20 años y practicar una revisión de la literatura sobre la patogenia, diagnóstico y tratamiento de estas lesiones.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se trata de un estudio retrospectivo descriptivo sobre 14 casos de empiemas epidurales espinales. Se analizaron las características epidemiológicas básicas, manifestaciones clínicas, datos analíticos, técnicas de diagnostico, actitudes terapéuticas usadas y los resultados obtenidos.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La serie esta formada por 7 varones y 7 mujeres con edades que oscilaron entre 8 y 76 años (media 48.9). En 12 casos el síntoma de presentación fue la presencia de dolor vertebral local, siempre en relación con la localización del empiema, siendo la duración media de la sintomatología de 9.3 días. La velocidad de sedimentación globular (VSG) estaba elevada en todos los casos y existía leucocitosis en trece pacientes (92.9%). En 11 casos (78.5%), la localización del empiema fue en la región dorsal. Trece pacientes fueron tratados mediante cirugía y uno recibió exclusivamente tratamiento antibiótico.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En pacientes con factores de riesgo (inmunosupresión, diabetes), la presencia de dolor espinal asociado a fiebre y alteraciones analíticas (leucocitosis/elevación de la VSG), deben ser estudiados con resonancia magnética espinal, ante el riesgo de desarrollar un empiema epidural. El tratamiento de elección es la combinación de la evacuación quirúrgica urgente y pauta antibiótica, ya que la demora en el tratamiento puede ocasionar lesiones neurológicas irreversibles. El tratamiento exclusivamente médico debe sólo reservarse para pacientes con elevado riesgo quirúrgico o que no presenten afectación neurológica.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The goal of this study was to review our series of spinal epidural empyema diagnosed in the last 20 years and review the literature regarding the pathogenesis, diagnosis and treatment of these lesions.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This is a retrospective study over 14 patients diagnosed of spinal epidural empyema. We review the epidemiological data, clinical symptoms, laboratory and imaging data, the treatment régimen and the results.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fourteen patients, 7 males and 7 females, with an age range from 8 to 76 years (mean 48.9) were identified. The first symptom was localized back/neck pain in 12 patients and the mean duration of symptoms was 9.3 days. Erythrocyte sedimentation rate (ESR) was elevated in all patients; peripheral leukocyte count was elevated in 13 cases (92.9%). Site of spinal epidural empyemas was distributed along the axis but in 11 cases the location was thoracic. Thirteen patients had surgery for debridement and spinal decompression and one patient was treated successfully with antibiotics alone.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Patients with localized back pain and fever who are at risk for developing such empyemas with elevation of white blood cells and increased ESR, should have an immediate magnetic resonance imaging sean. Urgent surgical drainage and antibiotic use are the treatment of choice in order to prevent irreversible neurological déficits. Nonsurgical treatment should be reserved for poor surgical candidates and patients without neurological déficits.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Gelabert-González, M.; González-García, J.; Fernández-Villa, J.M.; García-Allut, A.: R. Martínez-Rumbo, R.: Empiema epidural espinal. Análisis de 14 casos. Neurocirugía 2004; 15: 543–552.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:42 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infection as a cause of spinal cord compression: a review of 36 spinal epidural abscess cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Akalan" 1 => "T. Özgen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "2000" "volumen" => "142" "paginaInicial" => "17" "paginaFinal" => "23" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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