Empiema epidural espinal. Análisis de 14 casos
Spinal epidural empyema. Analysis of 14 cases
M. Gelabert-González
, J. González-García, J.M. Fernández-Villa, A. GarcíaAllut, R. Martínez-Rumbo
Servicio de Neurocirugía. Hospital Clínico Universitario de Santiago. Departamento de Cirugía. Universidad de Santiago de Compostela
Leído
4337
Vecesse ha leído el artículo
2880
Total PDF
1457
Total HTML
Compartir estadísticas
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." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Absceso epidural espinal secundario a traumatismo faríngeo alimentario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Ares" 1 => "J.M. Prieto" 2 => "M.D. Dapena" 3 => "A. García-Allut" 4 => "M. Lema" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "2001" "volumen" => "32" "paginaInicial" => "1049" "paginaFinal" => "1051" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11562827" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Absceso epidural dorsal secundario a anestesia epidural" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Barón" 1 => "J. Heredero" 2 => "I. Prieto" 3 => "M. Lousa" 4 => "J. Masjuan" 5 => "J.M. Gobernando" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurología" "fecha" => "1997" "volumen" => "12" "paginaInicial" => "262" "paginaFinal" => "264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9303596" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immunologic dysfunction in heroin addicts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.M. Brown" 1 => "B. Stimmel" 2 => "R.N. Taub" 3 => "S. Kochawa" 4 => "R.E. Rosenfield" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Archlntem Med" "fecha" => "1974" "volumen" => "134" "paginaInicial" => "1001" "paginaFinal" => "1006" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento percutáneo de absceso epidural vertebral y fractura-luxación con tetraparesia. Resúmenes de las comunicaciones presentadas en la VI reunión de la Sociedad Española de neurocirugía, Ávila, mayo 2001" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Clavel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Neurocirugía" "fecha" => "2001" "volumen" => "12" "paginaInicial" => "249" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Absceso epidural espinal cervical secundario a flemón dental" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "V.J. Correa-Nazco" 1 => "J.C. Romero-Pérez" 2 => "J. Domínguez" 3 => "M.J. Amérigo" 4 => "M. González-Febles" 5 => "I. Erdozaín-Ruiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "1999" "volumen" => "29" "paginaInicial" => "286" "paginaFinal" => "287" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10797909" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abscesses and inflammatory tumors in the spinal epidural space (so-called pachymeningitis externa)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.E. Dandy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Surg" "fecha" => "1926" "volumen" => "13" "paginaInicial" => "477" "paginaFinal" => "494" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bacterial spinal epidural abscess. Review of 43 cases and literatee survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.O. Darouiche" 1 => "R.J. Hamill" 2 => "S.B. Greeberg" 3 => "S.W. Weathers" 4 => "D.M. Musher" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Medicine" "fecha" => "1992" "volumen" => "71" "paginaInicial" => "369" "paginaFinal" => "385" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1359381" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidural spinal abscesses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Dei-Anang" 1 => "U. Hase" 2 => "K. Schürmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurg Rev" "fecha" => "1990" "volumen" => "13" "paginaInicial" => "285" "paginaFinal" => "288" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2149173" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute spinal epidural empyema. Observations from seven cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Firsching" 1 => "R.A. Frowein" 2 => "K. Nittner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neu rochir (Wien)" "fecha" => "1985" "volumen" => "74" "paginaInicial" => "68" "paginaFinal" => "71" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Absceso epidural cervical como causa de tetraparesia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. González-García" 1 => "M. Gelabert" 2 => "J. Bandín" 3 => "J.M. Villa" 4 => "A.G. Pravos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "1999" "volumen" => "29" "paginaInicial" => "727" "paginaFinal" => "730" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10560106" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A study of 49 patients with acute spinal extradural abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.O. Hancock" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sc.1973.52" "Revista" => array:6 [ "tituloSerie" => "Paraplegia" "fecha" => "1973" "volumen" => "10" "paginaInicial" => "285" "paginaFinal" => "288" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4697001" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess: a ten-year perspective" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.L. Hlavin" 1 => "H.J. Kaminsky" 2 => "J.S. Ross" 3 => "E. Ganz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1990" "volumen" => "27" "paginaInicial" => "177" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2385333" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess: a diagnostic challenge" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.M. Joshi" 1 => "R.H. Harfield" 2 => "J. Martin" 3 => "W. Taylor" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Br J Neuro surg" "fecha" => "2003" "volumen" => "17" "paginaInicial" => "160" "paginaFinal" => "163" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess: evaluation of factors influencing outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.K. Khanna" 1 => "G.M. Malik" 2 => "J.P. Rock" 3 => "M.L. Rosenblum" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1996" "volumen" => "39" "paginaInicial" => "958" "paginaFinal" => "964" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8905751" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extradural abscess in the postpartum period" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.J. Kitching" 1 => "A.C. Rice" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "1993" "volumen" => "70" "paginaInicial" => "703" "paginaFinal" => "704" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8329274" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and results of different treatment regimes in patients with spinal abscesses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Lange" 1 => "F. Tiecks" 2 => "E. Schielke" 3 => "T. Yousry" 4 => "R. Haberl" 5 => "R. Oeckler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1993" "volumen" => "125" "paginaInicial" => "105" "paginaFinal" => "114" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anterior cervical spinal epidural abscess in an infant" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.K. Lee" 1 => "J.H. Kim" 2 => "S.H. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Childs Nerv Syst" "fecha" => "1999" "volumen" => "15" "paginaInicial" => "137" "paginaFinal" => "139" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10230672" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Decreased morbidity from acute bacterial spinal epidural abscesses using computed tomography and nonsurgical treatment in selected patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D. Leys" 1 => "F. Lesoin" 2 => "C. Viaud" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ana.410170408" "Revista" => array:6 [ "tituloSerie" => "Ann Neurol" "fecha" => "1985" "volumen" => "17" "paginaInicial" => "350" "paginaFinal" => "355" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4004156" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of a holocord epidural abscess. Case illustration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Leonard" 1 => "B. Kaufman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2001" "volumen" => "94" "numero" => "Suppl 1" "paginaInicial" => "179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11147859" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adult spinal epidural abscess: clinical featees and prognostic factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "C.H. Lu" 1 => "W.N. Chang" 2 => "Ch. Lui" 3 => "H. Chang" 4 => "C.C. Lui" 5 => "P.Y. Lee" 6 => "H.W. Chang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Neurol Neurosurg" "fecha" => "2002" "volumen" => "104" "paginaInicial" => "306" "paginaFinal" => "310" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12140094" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess successfully treated with percutaneous, com puted tomography-guided, needle aspiration and parenteral antibiotic therapy: case report and review of the literatee" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.K. Lyu" 1 => "C.J. Chen" 2 => "L.M. Tang" 3 => "S.T. Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2002" "volumen" => "51" "paginaInicial" => "509" "paginaFinal" => "512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12182793" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Absceso epidural espinal. Presentación de un caso y revisión de la literatura" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.L. Llacer" 1 => "J.V. Pesudo" 2 => "F. Talamantes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurocirugía" "fecha" => "1996" "volumen" => "7" "paginaInicial" => "223" "paginaFinal" => "226" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess. Optimizing patient care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.R. Maslen" 1 => "S.R. Jones" 2 => "M.A. Crislip" 3 => "R. Bracis" 4 => "R.J. Dworkin" 5 => "J.E. Flemming" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Intem Med" "fecha" => "1933" "volumen" => "153" "paginaInicial" => "1713" "paginaFinal" => "1721" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess: presentation and treatment. A report of 21 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. McGee-Collet" 1 => "I.H. Johnston" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med J Aust" "fecha" => "1991" "volumen" => "155" "paginaInicial" => "14" "paginaFinal" => "17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1829780" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The pathogenesis of the spinal cord disorder associated with cervical spondylosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Nurick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Brain" "fecha" => "1972" "volumen" => "95" "paginaInicial" => "87" "paginaFinal" => "100" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5023093" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess: a report of 40 cases and review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E.S. Nussbaum" 1 => "D. Rigamonti" 2 => "H. Standiford" 3 => "Y. Numaguchi" 4 => "A.L. Wolf" 5 => "W.L. Robinson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Neurol" "fecha" => "1992" "volumen" => "38" "paginaInicial" => "225" "paginaFinal" => "231" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1359657" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess in hemodialysis patients: report of three cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.T. Obrador" 1 => "D.J. Levenson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "1996" "volumen" => "27" "paginaInicial" => "75" "paginaFinal" => "83" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8546141" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural empyema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.A. Pilkington" 1 => "S.A. Jackson" 2 => "G.R. Gillett" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Neurosurg" "fecha" => "2003" "volumen" => "17" "paginaInicial" => "196" "paginaFinal" => "200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12820767" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess: a meta-analysis of 915 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Reihsaus" 1 => "H. Waldbaur" 2 => "W. Seeling" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurg Rev" "fecha" => "2000" "volumen" => "23" "paginaInicial" => "175" "paginaFinal" => "204" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11153548" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidural abscess in the cervical spine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D. Rigamonti" 1 => "L. Liem" 2 => "A.L. Wolf" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Mt Sinai J Med" "fecha" => "1994" "volumen" => "61" "paginaInicial" => "357" "paginaFinal" => "362" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7969230" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New perspectives in acute spinal epidural abscess. Illustrated by two case reports" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Schmutzhard" 1 => "F. Aichner" 2 => "R.A. Dierckx" 3 => "F. Gersten-brand" 4 => "J. Willeit" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1986" "volumen" => "80" "paginaInicial" => "105" "paginaFinal" => "108" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Technical note. Pyogenic spinal epidural abscess: a minimally invasive technique for multisegmental decompression" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.D. Schultz Jr." 1 => "C.H. Comey" 2 => "R.W. Haid Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Spinal Disord" "fecha" => "2001" "volumen" => "14" "paginaInicial" => "546" "paginaFinal" => "549" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11723408" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscesses: clinical manifestations, prognostic factors, and outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Soehle" 1 => "T. Wallenfang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2002" "volumen" => "51" "paginaInicial" => "79" "paginaFinal" => "85" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12182438" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscesses: conservative treatment for selected subgroups of patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Sorensen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Neurosurg" "fecha" => "2003" "volumen" => "17" "paginaInicial" => "513" "paginaFinal" => "518" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14756477" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib36" "etiqueta" => "36." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Sypert, G.W.: Comentary to the paper of Curling ODJr, Gower DJ, Me Whorter JM: Changing concepts in spinal epidural abscess: a report of 29 cases. Neurosurgery 1990; 27: 185–192 (letter)." ] ] ] 36 => array:3 [ "identificador" => "bib37" "etiqueta" => "37." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess-review of 10 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Tacconi" 1 => "F.G. Johnston" 2 => "L. Symon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Neurochir (Wien)" "fecha" => "1996" "volumen" => "138" "paginaInicial" => "520" "paginaFinal" => "523" ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib38" "etiqueta" => "38." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spontaneous spinal epidural abscess in a neonate. With a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Tang" 1 => "C. Xenos" 2 => "S. Sgouros" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s003810100477" "Revista" => array:6 [ "tituloSerie" => "Childs Nerv Syst" "fecha" => "2001" "volumen" => "17" "paginaInicial" => "629" "paginaFinal" => "631" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11685529" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib39" "etiqueta" => "39." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Absceso epidural espinal: protocolo terapéutico. En: Resú menes de las comunicaciones presentadas en la VI reunión de la Sociedad Española de neurocirugía, Ávila, mayo 2001" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Teixidor" 1 => "J. Acebes" 2 => "J. Cabiol" 3 => "A. Cabarrós" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Neurocirugía" "fecha" => "2001" "volumen" => "12" "paginaInicial" => "212" ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib40" "etiqueta" => "40." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal epidural abscess: correlation between MRI fmdings and outeome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.A. Tung" 1 => "J.W.K. Yim" 2 => "L.A. Mermel" 3 => "L. Philip" 4 => "J.M. Rogg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neuroradiology" "fecha" => "1999" "volumen" => "41" "paginaInicial" => "904" "paginaFinal" => "909" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10639666" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib41" "etiqueta" => "41." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cervicothoracolumbar spinal epidural abscess with tetraparesis. Good recovery after non-surgical treatment with antibiotics and dexamethasone. Case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Wessling" 1 => "P. de las Heras" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurocirugía" "fecha" => "2003" "volumen" => "14" "paginaInicial" => "529" "paginaFinal" => "533" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14710309" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib42" "etiqueta" => "42." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidural abscess of the cer vical spine: case report and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.W. Williams" 1 => "T. Powell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/0007-1285-63-751-576" "Revista" => array:6 [ "tituloSerie" => "Br J Radiol" "fecha" => "1990" "volumen" => "63" "paginaInicial" => "576" "paginaFinal" => "578" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2390696" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/11301473/0000001500000006/v1_201305151229/S1130147304704406/v1_201305151229/es/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001500000006/v1_201305151229/S1130147304704406/v1_201305151229/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704406?idApp=UINPBA00004B" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 1 | 1 | 2 |
| 2022 Mayo | 0 | 1 | 1 |
| 2022 Febrero | 1 | 2 | 3 |
| 2021 Marzo | 0 | 1 | 1 |
| 2019 Febrero | 1 | 2 | 3 |
| 2018 Marzo | 3 | 0 | 3 |
| 2018 Febrero | 56 | 18 | 74 |
| 2018 Enero | 17 | 29 | 46 |
| 2017 Diciembre | 22 | 44 | 66 |
| 2017 Noviembre | 32 | 57 | 89 |
| 2017 Octubre | 15 | 38 | 53 |
| 2017 Septiembre | 23 | 47 | 70 |
| 2017 Agosto | 34 | 46 | 80 |
| 2017 Julio | 21 | 41 | 62 |
| 2017 Junio | 41 | 69 | 110 |
| 2017 Mayo | 47 | 48 | 95 |
| 2017 Abril | 29 | 77 | 106 |
| 2017 Marzo | 23 | 103 | 126 |
| 2017 Febrero | 19 | 130 | 149 |
| 2017 Enero | 14 | 50 | 64 |
| 2016 Diciembre | 45 | 46 | 91 |
| 2016 Noviembre | 50 | 95 | 145 |
| 2016 Octubre | 77 | 88 | 165 |
| 2016 Septiembre | 132 | 172 | 304 |
| 2016 Agosto | 117 | 74 | 191 |
| 2016 Julio | 65 | 84 | 149 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Julio | 0 | 8 | 8 |
| 2015 Junio | 16 | 34 | 50 |
| 2015 Mayo | 16 | 67 | 83 |
| 2015 Abril | 13 | 79 | 92 |
| 2015 Marzo | 18 | 74 | 92 |
| 2015 Febrero | 20 | 66 | 86 |
| 2015 Enero | 26 | 50 | 76 |
| 2014 Diciembre | 16 | 36 | 52 |
| 2014 Noviembre | 13 | 57 | 70 |
| 2014 Octubre | 18 | 60 | 78 |
| 2014 Septiembre | 19 | 55 | 74 |
| 2014 Agosto | 11 | 54 | 65 |
| 2014 Julio | 7 | 49 | 56 |
| 2014 Junio | 25 | 65 | 90 |
| 2014 Mayo | 30 | 64 | 94 |
| 2014 Abril | 17 | 44 | 61 |
| 2014 Marzo | 19 | 65 | 84 |
| 2014 Febrero | 13 | 44 | 57 |
| 2014 Enero | 16 | 50 | 66 |
| 2013 Diciembre | 23 | 27 | 50 |
| 2013 Noviembre | 18 | 42 | 60 |
| 2013 Octubre | 16 | 52 | 68 |
| 2013 Septiembre | 21 | 37 | 58 |
| 2013 Agosto | 36 | 35 | 71 |
| 2013 Julio | 28 | 29 | 57 |
| 2013 Junio | 16 | 42 | 58 |
| 2013 Mayo | 15 | 58 | 73 |
| 2013 Abril | 16 | 42 | 58 |
| 2013 Marzo | 17 | 35 | 52 |
| 2013 Febrero | 11 | 31 | 42 |
| 2013 Enero | 10 | 15 | 25 |
| 2012 Diciembre | 12 | 33 | 45 |
| 2012 Noviembre | 1 | 8 | 9 |
| 2012 Octubre | 0 | 8 | 8 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 17 | 0 | 17 |
Mostrar todo
