Mielopatía cervical: análisis retrospectivo de los resultados quirúrgicos de 54 pacientes tratados mediante discectomía y fusión intersomática por vía anterior

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"apellidos" => "Kaen" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014730570405X?idApp=UINPBA00004B" "url" => "/11301473/0000001600000003/v1_201305151239/S113014730570405X/v1_201305151239/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Mielopatía cervical: análisis retrospectivo de los resultados quirúrgicos de 54 pacientes tratados mediante discectomía y fusión intersomática por vía anterior" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "235" "paginaFinal" => "255" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Martín, J.R. Carda, F. Montiaga, J.I. Pinto, F. Sanz, B. Paternina, F. Trigueros, J.M. Izquierdo, A. Vázquez-Barquero" "autores" => array:9 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.R." "apellidos" => "Carda" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Montiaga" ] 3 => array:2 [ "nombre" => "J.I." "apellidos" => "Pinto" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Sanz" ] 5 => array:2 [ "nombre" => "B." "apellidos" => "Paternina" ] 6 => array:2 [ "nombre" => "F." "apellidos" => "Trigueros" ] 7 => array:2 [ "nombre" => "J.M." "apellidos" => "Izquierdo" ] 8 => array:2 [ "nombre" => "A." "apellidos" => "Vázquez-Barquero" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital Universitario Marqués de Valdecilla. Santander" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital Universitario “Marqués de Valdecilla”. Avenida Marqués de Valdecilla s/n. 39008 Santander." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cervical myelopathy: Retrospective analysis of surgical results in 53 cases treated by anterior cervical discectomy and interbody fusión" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-10-01" "fechaAceptado" => "2003-11-12" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158883" "palabras" => array:5 [ 0 => "Artrodesis intersomática" 1 => "Discectomía cervical" 2 => "Hernia discal cervical" 3 => "Mielopatía cervical" 4 => "Radiculopatía cervical" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158884" "palabras" => array:4 [ 0 => "Cervical discectomy" 1 => "Cervical disc herniation" 2 => "Cervical myelopathy" 3 => "Interbody fusión" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "Pacientes y métodosSe analiza de forma retrospectiva el resultado clínico de una serie consecutiva de 53 pacientes afectos de mielopatía o mielorradiculopatía cervical que fueron intervenidos mediante discectomía cervical y artrodesis por vía anterior utilizando la técnica de Cloward, con un seguimiento medio de 3 años. ResultadosEl 64.2% de los pacientes se benefició del tratamiento quirúrgico, mejorando en uno o más grados en la escala de Nurick. No se produjo mortalidad, aunque apareció deterioro neurológico en el 9.4% de los casos. Se objetivó una correcta fusión de los segmentos intervenidos en el 92.5% de las cirugías, desarrollando un 9.4% de los enfermos cifosis postquirúrgica. En el análisis multivariante se identificaron como factores relacionados con el resultado clínico: edad (p=0.008), presencia de factores de riesgo vascular (p=0.031), duración de la clínica (p=0.002), estado neurológico prequirúrgico (p<0.001), diagnóstico neurorradiológico (p=0.014), presencia de hiperseñal intramedular en las secuencias de resonancia magnética potenciadas en T2 (p=0.008), alteración de la conducción medular en el estudio neurofisiológico (p=0.004) y desarrollo de complicaciones quirúrgicas (p=0.012). ConclusionesDadas las discrepancias existentes en la actualidad, la optimización del tratamiento de estos pacientes pasa por una valoración individualizada, y por la realización de estudios prospectivos y randomizados que respondan a las preguntas cuándo y cómo operar." ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Patients and methodsWe perform a retrospective analysis of clinical results in 53 consecutive patients surgically treated for cervical myelopathy or myelo-radiculopathy with anterior cervical discectomy and interbody fusión by means of the Cloward procedure. Results64.2% of the patients had good outcome as measured by the improvement in one or more grades in the Nurick's scale. No mortality related to the surgical procedure was noted, although 9.4% of the cases suffered neurological deterioration. Correct fusión was achieved in 92.5% of the patients, with a rate of post-surgical kyphosis of 9.4%. Multivariate analysis identified as factors related to the clinical outcome: age (p=0.008), vascular risk factors (p=0.031), duration of symptoms (p=0.002), pre-surgical neurological status (p<0.001), neuroradiological diagnosis (p=0.014), intramedullary high signal intensity changes in T2-weighted images (p=0.008), prolongation of the central somatosensory or motor conduction times (p=0.004) and neurologic complications (p=0.012) ConclusionsTreatment optimisation of the patient suffering cervical spondylotic myelopathy requires individualised evaluation. Prospective randomised studies are needed to answer the questions when and how to opérate." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Martín, R.; Carda, J.F.; Montiaga, F.; Pinto, J.I.; Sanz, F.; Paternina, B.; Trigueros, F.; Izquierdo, J.M.; Vázquez-Barquero, A.: Mielopatía cervical: análisis retrospectivo de los resultados quirúrgicos de 54 pacientes tratados mediante discectomía y fusión intersomática por vía anterior. Neurocirugía 2005; 16: 235–255." ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:76 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Experimental chronic compressive cervical myelopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "O. al Mefty" 1 => "H.L. Harkey" 2 => "I. 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Cervical myelopathy: Retrospective analysis of surgical results in 53 cases treated by anterior cervical discectomy and interbody fusión

R. Martín

, J.R. Carda, F. Montiaga, J.I. Pinto, F. Sanz, B. Paternina, F. Trigueros, J.M. Izquierdo, A. Vázquez-Barquero

Servicio de Neurocirugía. Hospital Universitario Marqués de Valdecilla. Santander

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        "resumen" => "<span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se analiza de forma retrospectiva el resultado cl&#237;nico de una serie consecutiva de 53 pacientes afectos de mielopat&#237;a o mielorradiculopat&#237;a cervical que fueron intervenidos mediante discectom&#237;a cervical y artrodesis por v&#237;a anterior utilizando la t&#233;cnica de Cloward&#44; con un seguimiento medio de 3 a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El 64&#46;2&#37; de los pacientes se benefici&#243; del tratamiento quir&#250;rgico&#44; mejorando en uno o m&#225;s grados en la escala de Nurick&#46; No se produjo mortalidad&#44; aunque apareci&#243; deterioro neurol&#243;gico en el 9&#46;4&#37; de los casos&#46; Se objetiv&#243; una correcta fusi&#243;n de los segmentos intervenidos en el 92&#46;5&#37; de las cirug&#237;as&#44; desarrollando un 9&#46;4&#37; de los enfermos cifosis postquir&#250;rgica&#46; En el an&#225;lisis multivariante se identificaron como factores relacionados con el resultado cl&#237;nico&#58; edad &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#44; presencia de factores de riesgo vascular &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#44; duraci&#243;n de la cl&#237;nica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; estado neurol&#243;gico prequir&#250;rgico &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; diagn&#243;stico neurorradiol&#243;gico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;014&#41;&#44; presencia de hiperse&#241;al intramedular en las secuencias de resonancia magn&#233;tica potenciadas en T2 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#44; alteraci&#243;n de la conducci&#243;n medular en el estudio neurofisiol&#243;gico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; y desarrollo de complicaciones quir&#250;rgicas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dadas las discrepancias existentes en la actualidad&#44; la optimizaci&#243;n del tratamiento de estos pacientes pasa por una valoraci&#243;n individualizada&#44; y por la realizaci&#243;n de estudios prospectivos y randomizados que respondan a las preguntas cu&#225;ndo y c&#243;mo operar&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We perform a retrospective analysis of clinical results in 53 consecutive patients surgically treated for cervical myelopathy or myelo-radiculopathy with anterior cervical discectomy and interbody fusi&#243;n by means of the Cloward procedure&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">64&#46;2&#37; of the patients had good outcome as measured by the improvement in one or more grades in the Nurick&#39;s scale&#46; No mortality related to the surgical procedure was noted&#44; although 9&#46;4&#37; of the cases suffered neurological deterioration&#46; Correct fusi&#243;n was achieved in 92&#46;5&#37; of the patients&#44; with a rate of post-surgical kyphosis of 9&#46;4&#37;&#46; Multivariate analysis identified as factors related to the clinical outcome&#58; age &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#44; vascular risk factors &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#44; duration of symptoms &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;002&#41;&#44; pre-surgical neurological status &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; neuroradiological diagnosis &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;014&#41;&#44; intramedullary high signal intensity changes in T2-weighted images &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#44; prolongation of the central somatosensory or motor conduction times &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41; and neurologic complications &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;012&#41;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Treatment optimisation of the patient suffering cervical spondylotic myelopathy requires individualised evaluation&#46; Prospective randomised studies are needed to answer the questions when and how to op&#233;rate&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Mart&#237;n&#44; R&#46;&#59; Carda&#44; J&#46;F&#46;&#59; Montiaga&#44; F&#46;&#59; Pinto&#44; J&#46;I&#46;&#59; Sanz&#44; F&#46;&#59; Paternina&#44; B&#46;&#59; Trigueros&#44; F&#46;&#59; Izquierdo&#44; J&#46;M&#46;&#59; V&#225;zquez-Barquero&#44; A&#46;&#58; Mielopat&#237;a cervical&#58; an&#225;lisis retrospectivo de los resultados quir&#250;rgicos de 54 pacientes tratados mediante discectom&#237;a y fusi&#243;n intersom&#225;tica por v&#237;a anterior&#46; Neurocirug&#237;a 2005&#59; 16&#58; 235&#8211;255&#46;</p>"
      ]
    ]
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      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
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            0 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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            3 => array:3 [
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                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;C&#46; Benzel"
                            1 => "J&#46; Lancon"
                            2 => "L&#46; Kesterson"
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                          ]
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                            "web" => "Medline"
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                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cervical spondylo tic myelopathy and myelorradiculopathy&#58; anterior decompression and stabilization with autogenous f&#237;bula strut graft"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46;N&#46;J&#46; Bernard"
                            1 => "T&#46;S&#46;I&#46; Whitecloud"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
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                        "fecha" => "1987"
                        "volumen" => "221"
                        "paginaInicial" => "149"
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                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical long-term results of anterior discectomy without fusi&#243;n for treatment of cervical radiculopathy and myelopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Bertalanffy"
                            1 => "H&#46;R&#46; Eggert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
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                        "fecha" => "1988"
                        "volumen" => "90"
                        "paginaInicial" => "127"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cervical spondylosis and myelopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46;H&#46; Bohlman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
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                        "fecha" => "1995"
                        "volumen" => "44"
                        "paginaInicial" => "81"
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                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cervical spondylosis&#46; Prognostic valu&#233; of preoperative signs and symptoms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;A&#46; Brandt"
                            1 => "C&#46;A&#46; Fager"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
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                        "fecha" => "1976"
                        "volumen" => "34"
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                      ]
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                  ]
                ]
              ]
            ]
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              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Viscoelastic relaxation and regional blood flow response to spinal cord compression and decompression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;D&#46; Carlson"
                            1 => "K&#46;E&#46; Warden"
                            2 => "J&#46;M&#46; Barbeau"
                            3 => "E&#46; Bahniuk"
                            4 => "K&#46;L&#46; Kutina-Nelson"
                            5 => "C&#46;L&#46; Biro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "1997"
                        "volumen" => "22"
                        "paginaInicial" => "1285"
                        "paginaFinal" => "1291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9201829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictability of surgical results of herniated disc-induced cervical myelopathy based on spinal cord motor conduction study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;W&#46; Chang"
                            1 => "S&#46;M&#46; Lin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurg Rev"
                        "fecha" => "1999"
                        "volumen" => "22"
                        "paginaInicial" => "107"
                        "paginaFinal" => "111"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10547008"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intramedullary high signal intensity on T2-weighted MR images in cervical spondylotic myelopathy&#58; prediction of prognosis with type of intensity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;J&#46; Chen"
                            1 => "R&#46;K&#46; Lyu"
                            2 => "S&#46;T&#46; Lee"
                            3 => "Y&#46;C&#46; Wong"
                            4 => "L&#46;J&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1148/radiol.2213010365"
                      "Revista" => array:6 [
                        "tituloSerie" => "Radiology"
                        "fecha" => "2001"
                        "volumen" => "221"
                        "paginaInicial" => "789"
                        "paginaFinal" => "794"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11719680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cervical spondylotic myelopathy&#58; patterns of neurological d&#233;ficit and recovery after anterior cervical decompression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46;W&#46; Chiles 3d"
                            1 => "M&#46;A&#46; Leonard"
                            2 => "H&#46;F&#46; Choudhri"
                            3 => "P&#46;R&#46; Cooper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1999"
                        "volumen" => "44"
                        "paginaInicial" => "762"
                        "paginaFinal" => "770"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10201301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cervical spondylotic myelopathy&#58; History andphysicalfindings"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;R&#46; Clark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "1988"
                        "volumen" => "13"
                        "paginaInicial" => "847"
                        "paginaFinal" => "849"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3194794"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tratamiento quir&#250;rgico de la mielopat&#237;a cervical espondiloartr&#243;sica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Clavel-Escribano"
                            1 => "P&#46; Clavel-Laria"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "1996"
                        "volumen" => "7"
                        "paginaInicial" => "4"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Surgical treatment for cervical spondylitic myelopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Ebersold"
                            1 => "M&#46;C&#46; Pare"
                            2 => "L&#46;M&#46; Quast"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Surg Radiol Anat"
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Información del artículo

ISSN: 11301473
Idioma original: Español

DOI:10.1016/S1130-1473(05)70406-1

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