Papel de la cirugía en la enfermedad degenerativa espinal. Análisis de revisiones sistemáticas sobre tratamientos quirúrgicos y conservadores desde el punto de vista de la medicina basada en la evidencia
Role of surgery in spinal degenerative disease. Analysis of systematic reviews on surgical and conservative treatments from an evidence-based approach
P.D. Delgado-López
, A. Rodríguez-Salazar, J.M. Castilla-Diez, V. Martín-Velasco, O. Fernández-Arconada
Servicio de Neurocirugía. Hospital General Yagüe. Avda. del Cid 96. 09005 Burgos
Leído
2388
Vecesse ha leído el artículo
1295
Total PDF
1093
Total HTML
Compartir estadísticas
array:23 [ "pii" => "S1130147305704206" "issn" => "11301473" "doi" => "10.1016/S1130-1473(05)70420-6" "estado" => "S300" "fechaPublicacion" => "2005-01-01" "aid" => "70420" "copyright" => "Sociedad Española de Neurocirugía" "copyrightAnyo" => "2005" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2005;16:142-57" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2394 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 1092 "PDF" => 1285 ] ] "itemSiguiente" => array:18 [ "pii" => "S1130147305704218" "issn" => "11301473" "doi" => "10.1016/S1130-1473(05)70421-8" "estado" => "S300" "fechaPublicacion" => "2005-01-01" "aid" => "70421" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Neurocirugia. 2005;16:158-68" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1808 "formatos" => array:3 [ "EPUB" => 16 "HTML" => 970 "PDF" => 822 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Tratamiento de los gliomas mediante virus oncolíticos: revisión de la literatura" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "158" "paginaFinal" => "168" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Oncolytic viral terapy of gliomas: review of the literature" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Arrese, P. González, P. Miranda, A. Pérez-Núñez, B. Pascual, R.D. Lobato" "autores" => array:6 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Arrese" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "González" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Miranda" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Pérez-Núñez" ] 4 => array:2 [ "nombre" => "B." "apellidos" => "Pascual" ] 5 => array:2 [ "nombre" => "R.D." "apellidos" => "Lobato" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147305704218?idApp=UINPBA00004B" "url" => "/11301473/0000001600000002/v1_201305151236/S1130147305704218/v1_201305151236/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S113014730570419X" "issn" => "11301473" "doi" => "10.1016/S1130-1473(05)70419-X" "estado" => "S300" "fechaPublicacion" => "2005-01-01" "aid" => "70419" "copyright" => "Sociedad Española de Neurocirugía" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Neurocirugia. 2005;16:141" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1690 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 937 "PDF" => 736 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "Comentario al trabajo: <span class="elsevierStyleItalic">Mutismo acinético relacionado con hidrocefalia y cirugía cerebelosa tratado con bromocriptina y efedrina. Revisión fisiopatológica</span> de Mateo-Sierra y cols" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "141" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Brell" "autores" => array:1 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Brell" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014730570419X?idApp=UINPBA00004B" "url" => "/11301473/0000001600000002/v1_201305151236/S113014730570419X/v1_201305151236/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Papel de la cirugía en la enfermedad degenerativa espinal. Análisis de revisiones sistemáticas sobre tratamientos quirúrgicos y conservadores desde el punto de vista de la medicina basada en la evidencia" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "142" "paginaFinal" => "157" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P.D. Delgado-López, A. Rodríguez-Salazar, J.M. Castilla-Diez, V. Martín-Velasco, O. Fernández-Arconada" "autores" => array:5 [ 0 => array:3 [ "nombre" => "P.D." "apellidos" => "Delgado-López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez-Salazar" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Castilla-Diez" ] 3 => array:2 [ "nombre" => "V." "apellidos" => "Martín-Velasco" ] 4 => array:2 [ "nombre" => "O." "apellidos" => "Fernández-Arconada" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital General Yagüe. Avda. del Cid 96. 09005 Burgos" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital General Yagüe. Avda. del Cid 96, 09005 Burgos." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Role of surgery in spinal degenerative disease. Analysis of systematic reviews on surgical and conservative treatments from an evidence-based approach" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-08-18" "fechaAceptado" => "2004-10-14" "PalabrasClave" => array:2 [ "es" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158833" "palabras" => array:5 [ 0 => "Dolor lumbar crónico" 1 => "Discopatía degenerativa" 2 => "Fusion lumbar" 3 => "Instrumentación espinal" 4 => "Tratamientos conservadores" ] ] 1 => array:4 [ "clase" => "abr" "titulo" => "Abreviaturas" "identificador" => "xpalclavsec158832" "palabras" => array:4 [ 0 => "EDE" 1 => "MBE" 2 => "PIB" 3 => "SDD" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158834" "palabras" => array:5 [ 0 => "Low back pain" 1 => "Degenerative disc disease" 2 => "Lumbar fusion" 3 => "Spinal instrumentation" 4 => "Conservative treatments" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Alrededor del 70–80% de la población presentará dolor de espalda incapacitante algún momento en su vida como consecuencia de la Enfermedad Degenerativa Espinal (EDE). Los costes globales que genera la enfermedad se estiman en torno al 1–2% del PIB anualmente. Desde el punto de vista de la Medicina Basada en la Evidencia (MBE), se constata una llamativa discrepancia entre la enorme disponibilidad y creciente uso de técnicas quirúrgicas (en especial de fusión espinal) y la escasa evidencia científica que apoya su utilización.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hemos revisado cuidadosamente todos los metaanálisis referentes a tratamientos de la EDE publicados hasta Diciembre de 2003 y hemos clasificado las recomendaciones terapéuticas en niveles de evidencia (fuerte, moderada, limitada o ausencia de evidencia), tanto para tratamientos quirúrgicos como conservadores, siguiendo las pautas de la MBE.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Identificamos 44 metaanálisis de interés (9 sobre cirugía lumbar, 3 sobre cirugía cervical y 32 sobre otros tratamientos). Desde el punto de vista quirúrgico, sólo alcanza nivel de evidencia fuerte la laminectomía precoz en síndrome de cola de caballo por extrusión discal; la superioridad de la discectomía simple o microdiscectomía frente a quimionucleolisis en prolapso discal y espondilosis; y la cirugía de fusión (en principio, no instrumentada) en espondilolistesis ístmica del adulto o degenerativa asociada a estenosis lumbar. En espondilosis cervical con radiculo y/o mielopatía cervical leve, la discectomía más fusión no supera a la discectomía simple y ésta es dudosamente superior a la historia natural de la enfermedad más allá de 24 meses. La utilización profiláctica de antibióticos en cirugía espinal es beneficiosa. No se demuestra beneficio de la cirugía en dolor discogénico. Ninguna terapia conservadora alcanza el nivel de evidencia fuerte. Los antidepresivos mejoran la percepción del dolor pero no la funcionalidad.</p> <span class="elsevierStyleSectionTitle">Discusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A pesar de que se ha doblado el porcentaje de cirugías de instrumentación lumbar en las últimas dos décadas y crece a un ritmo del 20% anual, no se ha demostrado de forma fehaciente una mejoría en los resultados clínicos ni siquiera en las tasas globales de artrodesis. Este llamativo incremento del uso de la cirugía en procesos diferentes a las deformidades espinales y espondilolistesis aisladas o acompañadas de estenosis del canal lumbar, quizá obedece a múltiples factores técnicos y clínico-epidemiológicos donde no podemos obviar la enorme trascendencia económica que subyace. Resulta crucial diferenciar qué subgrupos de pacientes con EDE se benefician claramente de la cirugía. Desde el punto de vista ético empieza a plantearse la necesidad de diseñar ensayos clínicos que incorporen placebos quirúrgicos, dada la escasa evidencia científica que apoya la cirugía espinal a día de hoy. La mayor parte de los tratamientos conservadores tienen una eficacia moderada o leve (casi siempre transitoria) y, probablemente, deban utilizarse en combinación.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La cirugía de la EDE se asienta sobre pilares inseguros habida cuenta de que la mayor parte de las técnicas que se indican no están avaladas por recomendaciones de primera clase en términos de MBE. Parece necesario consensuar, desde las organizaciones que estudian la columna degenerativa, guías de práctica clínica en lo referente al tratamiento integral y multidisciplinado de la EDE, a sabiendas que, hasta hoy, pocos tratamientos alteran de forma positiva y duradera la historia natural de la enfermedad.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The lifetime prevalence of invalidating back pain in general population caused by Spinal Degenerative Disease (SDD) is about 70–80%. Global costs related to this disease are enormous (1–2% gross domestic product). From an Evidence-based point of view, there is a striking discrepancy between the use of many available surgical techniques (especially for spinal fusion) and the lack of scientific support.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The authors carefully reviewed all published metaanalysis on SDD therapies up to December 2003. Treatment recommendations were classifled according to leveis of evidence (strong, modérate, mild or lack of evidence) for both surgical and conservative measures.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Forty-four metaanalysis were selected (nine on lumbar surgery, three on cervical surgery and thirty-two on other therapies). Relating surgery, there is strong evidence favouring early laminectomy in cauda equina syndrome secondary to lumbar disc herniation; discectomy or microdiscectomy are superior to chemonucleolysis in lumbar prolapse and spondylosis; and fusion surgery (probably noninstrumented) in adult isthmic spondylolysthesis or degenerative spondylolys-thesis with spinal stenosis. In cervical spondylosis and radiculomyelopathy, discectomy seems as efective as discectomy plus fusion, which does not seem to be better than untreated SDD beyond 24 months. Preoperative antibiotics seem to prevent infection in spinal surgery. No beneflt of surgery is demonstrated in discogenic pain. None of conservative therapies are supported by strong evidence. Antidepressants improve pain perception but do not influence the functional status.</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Although lumbar instrumented surgery has nearly doubled over two decades and the anual growth is about 20%, clinical results do not seem to have improved, not even global fusion rates. The increasing use of fusion surgery for cases other than spinal deformities, spondylolysthesis or spinal stenosis plus lysthesis may be related to multiple technical and clinical-epidemiological factors where huge flnancial and commercial interests must be considered. It is crucial to differenciate subsets of patients prone to beneft from surgery. It is discussed whether randomized trials incorporating sham operations are ethically justifiable, because of the lack of sould evidence for many spinal procedures. The efflcacy of most conservative treatments is mild or modérate (mainly transient) and they should be probably used in combination.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">There is no strong evidence favouring most of surgical procedures for SDD from an evidence-based approach. It seems neccessary that scientific organizations studying SDD créate clinical guidelines relating its multidisciplinary and integral management, recognizing that, up to now, few interventions positively modify in the long-term the natural history of the disease.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Delgado-López, P.D.; Rodríguez-Salazar, A.; José Manuel Castilla-Diez, J.M.; Martín-Velasco, V.; Fernández-Arconada, O.: Papel de la cirugía en la enfermedad degenerativa espinal. Análisis de revisiones sistemáticas sobre tratamientos quirúrgicos y conservadores desde el punto de vista de la medicina basada en la evidencia. Neurocirugía, 2005; 16: 142–157.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:75 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cauda equina symdrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "U.M. Ahn" 1 => "U.N. Ahn" 2 => "J.M. Buchowsky" 3 => "E.S. Garrett" 4 => "A.N. Sieber" 5 => "J.P. Kostuik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2000" "volumen" => "25" "paginaInicial" => "1515" "paginaFinal" => "1522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10851100" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "U.N. Ahn" 1 => "U.M. Ahn" 2 => "L. Nallamshetty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Spinal Disord" "fecha" => "2001" "volumen" => "14" "paginaInicial" => "427" "paginaFinal" => "433" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11586143" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Electrical stimulation as an adjunct to spinal fusion: a metaanalysis of controlled clinical trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Akai" 1 => "M. Kawashima" 2 => "T. Kimura" 3 => "K. Hayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Bioelectromagnetics" "fecha" => "2002" "volumen" => "232" "paginaInicial" => "493" "paginaFinal" => "504" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effectiveness of chiropractic for treatment of low back pa an update attempted at statistical pooling" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.J. Assendelft" 1 => "B.W. Koes" 2 => "G.J. van der Heijden" 3 => "L.M. Bouter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J. Manipulative Physiol Ther" "fecha" => "1996" "volumen" => "19" "paginaInicial" => "499" "paginaFinal" => "507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8902660" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal manipulative therapy for low back pain A meta-analysis of effectiveness relative to other terapies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.J. Assendelft" 1 => "S.C. Morton" 2 => "E.I Yu" 3 => "M.J. Suttorp" 4 => "P.G. Shekelle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2003" "volumen" => "138" "paginaInicial" => "871" "paginaFinal" => "881" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12779297" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of prophylactic antibiotic therapy in spinal surgery: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F. Barker 2<span class="elsevierStyleSup">nd</span>" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2002" "volumen" => "51" "paginaInicial" => "391" "paginaFinal" => "400" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12182777" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term functional outcome of pedicle screw instrumentation as a support for posterolateral spinal fusion: randomized clinical study with a 5-year followup" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Bjarke Christensen" 1 => "E. Stender Hansen" 2 => "M. Laureen" 3 => "K. Thomsen" 4 => "C.E. Bunger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2002" "volumen" => "27" "paginaInicial" => "1269" "paginaFinal" => "1277" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12065973" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Critical analysis of trends in fusion for degenerative disc disease over the past 20 years: influence of technique on fusion rate and clinical outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.M. Bono" 1 => "C.K. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2004" "volumen" => "29" "paginaInicial" => "455" "paginaFinal" => "463" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15094543" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An update review of epidemiologic studies on the relationship between exposure to whole-body vibration and low back pain (1986–1997)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Bovenzi" 1 => "C.T. Hulshof" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int ArchOccup Environ Health" "fecha" => "1999" "volumen" => "72" "paginaInicial" => "351" "paginaFinal" => "365" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L. Brosseau" 1 => "S. Milne" 2 => "V. Robinson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2002" "volumen" => "27" "paginaInicial" => "596" "paginaFinal" => "603" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11884907" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is INFUSE bone graft superior to autograft bone? An integrated analysis of clinical trials usin the LT-CAGE lumbar tapered fusion device" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.K. Burkus" 1 => "S.E. Heim" 2 => "M.F. Gornet" 3 => "T.A. Zdeblick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Spinal Disord Tech" "fecha" => "2003" "volumen" => "16" "paginaInicial" => "113" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12679664" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Single level posterolateral arthrodesis with or without posterior decompression for the treatment of isthmic spondylolisthesis in adults: a prospective, randomised study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E.J. Caragee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Sone Joint Surg Am" "fecha" => "1997" "paginaInicial" => "1175" "paginaFinal" => "1180" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Report of a controlled clinical trial comparing automated percutaneous lumbar discectomy and microdiscectomy in the treatment of contained lumbar disc herniation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Chatterjee" 1 => "P.M. Foy" 2 => "G.F. Findlay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1995" "volumen" => "20" "paginaInicial" => "734" "paginaFinal" => "738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7604351" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Total disc replacement for chronic low back pain: background and a systematic review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. De Kleuver" 1 => "F.C. Oner" 2 => "W.C. Jacobs" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00586-002-0500-0" "Revista" => array:6 [ "tituloSerie" => "Eur Spine J" "fecha" => "2003" "volumen" => "12" "paginaInicial" => "108" "paginaFinal" => "116" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12709847" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinalfusion surgery The case for restraint" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.A. Deyo" 1 => "A. Nachemson" 2 => "S.K. Mirza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMsb031771" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2004" "volumen" => "350" "paginaInicial" => "722" "paginaFinal" => "726" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14960750" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acupuncture for low back pain: a meta-analysis of randomizaed controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Ernst" 1 => "A.R. White" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "1998" "volumen" => "158" "paginaInicial" => "2235" "paginaFinal" => "2241" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9818803" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acupuncture, transcutaneous electrical nerve stimulation and laser therapy in chronic pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Fargas-Babjak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin J Pain" "fecha" => "2001" "volumen" => "17" "numero" => "suppl" "paginaInicial" => "S105" "paginaFinal" => "S113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11783823" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective randomized study comparing decompressive laminectomy and arthrodesis with and without instrumentation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.S. Fischgrund" 1 => "M. Mackay" 2 => "H.M. Herkowitz" 3 => "R. Brower" 4 => "D.M. Montgomery" 5 => "L.T. Kurz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1997" "volumen" => "22" "paginaInicial" => "2807" "paginaFinal" => "2812" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9431616" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of multidisciplinary pain treatment centers: a meta-analytic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Flor" 1 => "T. Fydrich" 2 => "D.C. Turk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pain" "fecha" => "1992" "volumen" => "49" "paginaInicial" => "221" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1535122" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A meta-analysis of autograft versus allograft in anterior cervical fusion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Floyd" 1 => "D. Ohnmeiss" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Spine J" "fecha" => "2000" "volumen" => "9" "paginaInicial" => "398" "paginaFinal" => "403" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11057533" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cochrane review on the role of surgery in cervical spondylotic radiculomyelopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I.P. Fouyas" 1 => "P.F. Statham" 2 => "P.A. Sandercock" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2002" "volumen" => "27" "paginaInicial" => "736" "paginaFinal" => "747" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11923667" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Magnetic Resonance imaging fmdings 10 years after treatment for lumbar disc herniation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.D. Fraser" 1 => "A. Sandhu" 2 => "W.J. Gogan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1995" "volumen" => "20" "paginaInicial" => "710" "paginaFinal" => "714" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7604347" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic low back pain and fusion: a comparison of three surgical techniques: a prospective multicenter randomized study from the Swedish Lumbar Spine Study Group" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Fritzell" 1 => "O. Hagg" 2 => "P. Wesberg" 3 => "A. Nordwall" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2002" "volumen" => "27" "paginaInicial" => "1131" "paginaFinal" => "1141" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12045508" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A critical review of reviews on the treat ment of chronic low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.D. Furlan" 1 => "J. Clarke" 2 => "R. Esmail" 3 => "S. Sinclair" 4 => "E. Irvin" 5 => "C. Bombardier" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2001" "volumen" => "26" "paginaInicial" => "E155" "paginaFinal" => "E162" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11295917" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Cochrane Review of surgery for lumbar disc prolapse and degenerative lumbar spondylosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.N. Gibson" 1 => "L.C. Grant" 2 => "G. Waddell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1999" "volumen" => "24" "paginaInicial" => "1820" "paginaFinal" => "1832" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10488513" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A review of the association between cigarrette smoking and the development of non specific back pain and related outeomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.S. Goldberg" 1 => "S.C. Scott" 2 => "N.E. Mayo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2000" "volumen" => "25" "paginaInicial" => "995" "paginaFinal" => "1014" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10767814" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Degenerative Lumbar spinal stenosis: decompression with and without arthrodesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Grob" 1 => "T. Hunke" 2 => "J. Dvorak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Bone Surg Am" "fecha" => "1995" "volumen" => "77" "paginaInicial" => "1036" "paginaFinal" => "1041" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7608225" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conservative management of mechanical neck disorders. A systematic overview and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.R. Gross" 1 => "P.D. Aker" 2 => "C.H. Goldsmith" 3 => "P. Peloso" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Online J Curr Clin Trials" "fecha" => "1996" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Does sitting at work cause low back pain?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Harrvigsen" 1 => "C. Leboeuf-Yde" 2 => "S. Lings" 3 => "E.H. Corder" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ugeskr Laeger" "fecha" => "2002" "volumen" => "164" "paginaInicial" => "759" "paginaFinal" => "761" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11851181" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A Con trolled Study of microsurgical versus standard lumbar discec tomy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L. Henrikson" 1 => "V. Schmidt" 2 => "V. Eskesen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Neurosurg" "fecha" => "1996" "volumen" => "10" "paginaInicial" => "289" "paginaFinal" => "293" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8799541" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective study comparing decompression with decompression and intertransverse process arthrodesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.N. Herkowitz" 1 => "L.T. Kurz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg Am" "fecha" => "1991" "volumen" => "73" "paginaInicial" => "802" "paginaFinal" => "808" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2071615" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgery for herniated lumbar dises: a literature synthesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.M. Hoffman" 1 => "K.J. Wheeler" 2 => "R.A. Deyo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Gen Intern Med." "fecha" => "1993" "volumen" => "8" "paginaInicial" => "487" "paginaFinal" => "496" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8410420" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is placebo surgery unethical?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Horng" 1 => "F.G. Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMsb021025" "Revista" => array:6 [ "tituloSerie" => "N. Engl J Med" "fecha" => "2002" "volumen" => "347" "paginaInicial" => "137" "paginaFinal" => "139" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12110744" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomi zed clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Ivar Brox" 1 => "R. Sorenson" 2 => "A. Friis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.BRS.0000083234.62751.7A" "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2003" "volumen" => "28" "paginaInicial" => "1913" "paginaFinal" => "1921" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12973134" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of lumbar spine fusion: plain radiographs versus direct surgical exploration and observation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A.P. Kant" 1 => "W.J. Daum" 2 => "S.M. Dean" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1995" "volumen" => "20" "paginaInicial" => "2313" "paginaFinal" => "2317" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8553119" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib36" "etiqueta" => "36." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lumbar laminec tomy alone or with instrumented or noninstrumented arthrodesis in degenerative lumbar spinal stenosis: patient selection, costs, and surgical outeomes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.N. Katz" 1 => "S.J. Lipson" 2 => "R.A. Lew" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1997" "volumen" => "22" "paginaInicial" => "1123" "paginaFinal" => "1131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9160471" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib37" "etiqueta" => "37." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Review of safety in endoscopio laser foraminoplasty for the management of back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.T. Knight" 1 => "D.R. Ellison" 2 => "A. Goswami" 3 => "V.F. Hillier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/10445470152927982" "Revista" => array:6 [ "tituloSerie" => "J Clin Laser Med Surg" "fecha" => "2001" "volumen" => "19" "paginaInicial" => "147" "paginaFinal" => "157" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11469307" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib38" "etiqueta" => "38." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of epidural steroid injections for low back pain and sciatica: a systematic review of randomized clinical trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.W. Koes" 1 => "R.J. Scholten" 2 => "J.M. Mens" 3 => "L.M. Bouter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pain" "fecha" => "1995" "volumen" => "63" "paginaInicial" => "279" "paginaFinal" => "288" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8719528" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib39" "etiqueta" => "39." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The efficacy of back schools: a review of rando mized clinical trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.W. Koes" 1 => "M.W. van Tulder" 2 => "W.M. van der Windt" 3 => "L.M. Bouter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Epidemiol" "fecha" => "1994" "volumen" => "47" "paginaInicial" => "851" "paginaFinal" => "862" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7730888" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib40" "etiqueta" => "40." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Local and remote sustained trigger point therapy for exacerbations of chronic low back pain. A randomized, double blind, controlled multicenter trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "F.M. Kovacs" 1 => "V. Abraira" 2 => "F. Pozo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1997" "volumen" => "22" "paginaInicial" => "786" "paginaFinal" => "797" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9106321" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib41" "etiqueta" => "41." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effectiveness and cost-effectiveness analysis of neuroreflexotherapy for subacute and chronic low back pain in routine general practice: a cluster, randomized, controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.M. Kovacs" 1 => "J. Llobera" 2 => "V. Abraira" 3 => "R. Lazaro" 4 => "F. Pozo" 5 => "D. Kleinbaum" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2002" "volumen" => "27" "paginaInicial" => "1149" "paginaFinal" => "1159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12045510" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib42" "etiqueta" => "42." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparative study of disc surgery with or without microscsopy: a prospective study of 80 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Lagarriage" 1 => "R. Chaines" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurochirurgie" "fecha" => "1994" "volumen" => "40" "paginaInicial" => "116" "paginaFinal" => "120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7870244" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib43" "etiqueta" => "43." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effectiveness of four interventions for the prevention of low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Lahad" 1 => "A.D. Malter" 2 => "A.O. Berg" 3 => "R.A. Deyo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "1994" "volumen" => "272" "paginaInicial" => "1286" "paginaFinal" => "1291" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7933374" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib44" "etiqueta" => "44." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of interposition membrane on the outcome of lumbar laminectomy and discectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.A. MacKay" 1 => "J.S. Fischgrund" 2 => "H.M. Herkowitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1995" "volumen" => "20" "paginaInicial" => "1793" "paginaFinal" => "1796" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7502136" "web" => "Medline" ] ] ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib45" "etiqueta" => "45." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "5-year reoperation rates after different types of lumbar spine surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.D. Malter" 1 => "B. McNeney" 2 => "J.D. Loeser" 3 => "R.A. Deyo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1998" "volumen" => "23" "paginaInicial" => "814" "paginaFinal" => "820" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9563113" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib46" "etiqueta" => "46." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Degenerative lumbar spondylosis: a meta-analysis of literature 19701993" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.M. Mardjetko" 1 => "P.J. Connolly" 2 => "S. Shott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Spine" "fecha" => "1994" "volumen" => "20S" "paginaInicial" => "2256S" "paginaFinal" => "2265S" ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib47" "etiqueta" => "47." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Strengthening lumbar extensors therapy of chronic back pain: an overview and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Miltner" 1 => "D.C. Wirtz" 2 => "C.H. Siebert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2001-16912" "Revista" => array:6 [ "tituloSerie" => "Z Orthop Ihre Grenzgeb" "fecha" => "2001" "volumen" => "139" "paginaInicial" => "287" "paginaFinal" => "293" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11558044" "web" => "Medline" ] ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib48" "etiqueta" => "48." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgery versus conservative management in adult isthmic spondylolisthesis - a prospective randomized study: part 1" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Moller" 1 => "R. Hedlund" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2000" "volumen" => "25" "paginaInicial" => "1711" "paginaFinal" => "1715" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10870148" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib49" "etiqueta" => "49." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neck and back pain. The scientific evidence of causes, diagnosis and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Nachemson" 1 => "E. Jonsson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2000" "editorial" => "Lippincott Williams & Wilkins" "editorialLocalizacion" => "Philadelphia" ] ] ] ] ] ] 49 => array:3 [ "identificador" => "bib50" "etiqueta" => "50." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of Neck and Back Pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Nachemson" 1 => "G. Waddell" 2 => "A.I. Norlund" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Neck and back pain. The scientific evidence of causes, diagnosis and treatment." "paginaInicial" => "165" "paginaFinal" => "188" "serieFecha" => "2000" ] ] ] ] ] ] 50 => array:3 [ "identificador" => "bib51" "etiqueta" => "51." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiofrequency denervation for neck and back pain. A systematic review of randomized controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Niemisto" 1 => "E. Kalso" 2 => "A. Malmivaara" 3 => "S. Seitsalo" 4 => "H. Hurri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2003" "numero" => "l" ] ] ] ] ] ] 51 => array:3 [ "identificador" => "bib52" "etiqueta" => "52." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of surgical procedures for degenerative lumbar spinal stenosis: a meta-analysis of the literature from 1975 to 1995" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Niggemeyer" 1 => "J.M. Strauss" 2 => "K.P. Schulitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Spine J" "fecha" => "1997" "volumen" => "6" "paginaInicial" => "423" "paginaFinal" => "429" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9455673" "web" => "Medline" ] ] ] ] ] ] ] ] 52 => array:3 [ "identificador" => "bib53" "etiqueta" => "53." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of ADCON-L to inhibit postoperative peridural fibrosis and related symptoms following lumbar dise surgery: a preliminary report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.L. Petrie" 1 => "J.S. Ross" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Eur Spine J" "fecha" => "1996" "volumen" => "5" "numero" => "suppl 1" "paginaInicial" => "S10" "paginaFinal" => "S17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8915645" "web" => "Medline" ] ] ] ] ] ] ] ] 53 => array:3 [ "identificador" => "bib54" "etiqueta" => "54." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Philadelphia Panel.: Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions forlow back pain. Phys Ther 2001; 81: 641–1674" ] ] ] 54 => array:3 [ "identificador" => "bib55" "etiqueta" => "55." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Money matters: a meta-analytic review of the association between financial compensation and the experience and treatment of chronic pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.L. Rohling" 1 => "L.M. Binder" 2 => "J. Langhinrischsen-Rohling" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Health Psychol" "fecha" => "1995" "volumen" => "14" "paginaInicial" => "537" "paginaFinal" => "547" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8565928" "web" => "Medline" ] ] ] ] ] ] ] ] 55 => array:3 [ "identificador" => "bib56" "etiqueta" => "56." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of antidepressant treatment on chronic back pain: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.M. Salerno" 1 => "R. Browning" 2 => "J.L. Jackson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med" "fecha" => "2002" "volumen" => "162" "paginaInicial" => "19" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11784215" "web" => "Medline" ] ] ] ] ] ] ] ] 56 => array:3 [ "identificador" => "bib57" "etiqueta" => "57." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prospective randomized study of anterior single-level cervical disc operations with long-term foliow-up: surgical fusion is unnecessary" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Savolainen" 1 => "J. Rinne" 2 => "J. Hernesniemi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1998" "volumen" => "43" "paginaInicial" => "51" "paginaFinal" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9657188" "web" => "Medline" ] ] ] ] ] ] ] ] 57 => array:3 [ "identificador" => "bib58" "etiqueta" => "58." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microsurgery of lumbar dise prolapse. Superior results of microsurgery as compared to standard and percutaneous procedures (review of literature)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "U.D. Schmid" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Nervenartz" "fecha" => "2000" "volumen" => "71" "paginaInicial" => "265" "paginaFinal" => "274" ] ] ] ] ] ] 58 => array:3 [ "identificador" => "bib59" "etiqueta" => "59." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Work conditioning, work hardening and functional restoration for workers with back and neck pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Schonstein" 1 => "D.T. Kenny" 2 => "J. Keating" 3 => "B.W. Koes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Cochrane Datábase Syst Rev" "fecha" => "2003" ] ] ] ] ] ] 59 => array:3 [ "identificador" => "bib60" "etiqueta" => "60." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Teaasinga part quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.A. Smith" 1 => "A.D. Oldman" 2 => "H.J. McQuay" 3 => "R.A. Moore" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pain" "fecha" => "2000" "volumen" => "86" "paginaInicial" => "119" "paginaFinal" => "132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10779669" "web" => "Medline" ] ] ] ] ] ] ] ] 60 => array:3 [ "identificador" => "bib61" "etiqueta" => "61." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Return-to-work interventions for low back pain: a descriptive review of contents and concepts of working mechanisms" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.B. Staal" 1 => "H. Hlobil" 2 => "M.W. van Tulder" 3 => "A.J. Koke" 4 => "T. Smid" 5 => "W. van Mechelen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Sports Med" "fecha" => "2002" "volumen" => "32" "paginaInicial" => "251" "paginaFinal" => "267" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11929354" "web" => "Medline" ] ] ] ] ] ] ] ] 61 => array:3 [ "identificador" => "bib62" "etiqueta" => "62." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of pedicle screw instrumentation on functional outcome and fusion rates in posterolateral lumbar spinal fusion: a prospective randomized clinical study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K. Thomsen" 1 => "F.B. Christensen" 2 => "S.P. Eiskjaer" 3 => "E.S. Hansen" 4 => "S. Fruensgaard" 5 => "C.E. Bunger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1997" "volumen" => "22" "paginaInicial" => "2813" "paginaFinal" => "2822" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9431617" "web" => "Medline" ] ] ] ] ] ] ] ] 62 => array:3 [ "identificador" => "bib63" "etiqueta" => "63." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgery for lumbar spinal stenosis. Attempted meta-analysis of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.A. Turner" 1 => "M. Ersek" 2 => "L. Herrón" 3 => "R. Deyo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2012.6.AOSPINE12632" "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1992" "volumen" => "17" "paginaInicial" => "1" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22985363" "web" => "Medline" ] ] ] ] ] ] ] ] 63 => array:3 [ "identificador" => "bib64" "etiqueta" => "64." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis of results of lumbar spine fusion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Turner" 1 => "L. Herrón" 2 => "R.A. Deyo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Orthop Scand" "fecha" => "1993" "volumen" => "64" "numero" => "suppl 251" "paginaInicial" => "120" "paginaFinal" => "122" ] ] ] ] ] ] 64 => array:3 [ "identificador" => "bib65" "etiqueta" => "65." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal cord stimulation for chronic low back pain: a systhematic literature synthesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Turner" 1 => "J.D. Loeser" 2 => "K.G. Bell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1995" "volumen" => "37" "paginaInicial" => "1088" "paginaFinal" => "1095" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8584149" "web" => "Medline" ] ] ] ] ] ] ] ] 65 => array:3 [ "identificador" => "bib66" "etiqueta" => "66." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of spinal cord stimulation: 10 years of experience in a pain center in Belgium" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.P. Van Buyten" 1 => "J. Van Zundert" 2 => "P. Vueghs" 3 => "L. Vanduffel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/eujp.2001.0249" "Revista" => array:6 [ "tituloSerie" => "Eur J Pain" "fecha" => "2001" "volumen" => "5" "paginaInicial" => "299" "paginaFinal" => "307" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11558985" "web" => "Medline" ] ] ] ] ] ] ] ] 66 => array:3 [ "identificador" => "bib67" "etiqueta" => "67." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vocational outcome of intervention for low back pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "W.E. Van der Weide" 1 => "J.H. Verbeek" 2 => "M.W. van Tulder" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Scand J Work Environ Health" "fecha" => "1997" "volumen" => "23" "paginaInicial" => "165" "paginaFinal" => "178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9243726" "web" => "Medline" ] ] ] ] ] ] ] ] 67 => array:3 [ "identificador" => "bib68" "etiqueta" => "68." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stoop and squat: a review of biomechanical studies on lifting technique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.H. Van Dieen" 1 => "M.J. Hoozemans" 2 => "H.M. Toussaint" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "ClinBiomech" "fecha" => "1999" "volumen" => "14" "paginaInicial" => "685" "paginaFinal" => "696" ] ] ] ] ] ] 68 => array:3 [ "identificador" => "bib69" "etiqueta" => "69." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mechanisms of action of lumbar supports: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.N. Van Poppel" 1 => "M.P. de Looze" 2 => "B.W. Koes" 3 => "T. Smid" 4 => "L.M. Bouter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "2000" "volumen" => "25" "paginaInicial" => "2103" "paginaFinal" => "2113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10954643" "web" => "Medline" ] ] ] ] ] ] ] ] 69 => array:3 [ "identificador" => "bib70" "etiqueta" => "70." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effectiveness of acupuncture in the management of acute and chronic low back pain. A systematic review within the framework of the Cochrane Collaboration Back Review Group" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.W. Van Tulder" 1 => "D.C. Cherkin" 2 => "B. Berman" 3 => "L. Lao" 4 => "B.W. Koes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Spine" "fecha" => "1999" "volumen" => "24" "paginaInicial" => "1113" "paginaFinal" => "1123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10361661" "web" => "Medline" ] ] ] ] ] ] ] ] 70 => array:3 [ "identificador" => "bib71" "etiqueta" => "71." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conservative treatment of chronic lowback pain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.W. Van Tulder" 1 => "M. Goosens" 2 => "G. Waddell" 3 => "A. Nachemson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Neck and back pain. The scientific evidence of causes, diagnosis and treatment." "paginaInicial" => "271" "paginaFinal" => "304" "serieFecha" => "2000" ] ] ] ] ] ] 71 => array:3 [ "identificador" => "bib72" "etiqueta" => "72." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic low back pain: exercise therapy, multidisciplinary programs, NSAID's, back schools behavioral therapy effective; traction not effective; results od systematic reviews" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.W. Van Tulder" 1 => "B.W. Koes" 2 => "W.J. Assendelft" 3 => "L.M. Bouter" 4 => "L.D. Maljers" 5 => "A.P. Driessen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ned Tijdschr Geneeskd" "fecha" => "2000" "volumen" => "144" "paginaInicial" => "1489" "paginaFinal" => "1494" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10941436" "web" => "Medline" ] ] ] ] ] ] ] ] 72 => array:3 [ "identificador" => "bib73" "etiqueta" => "73." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Point of view" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Waddell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Spine" "fecha" => "2004" ] ] ] ] ] ] 73 => array:3 [ "identificador" => "bib74" "etiqueta" => "74." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical Treatment of lumbar dise prolapse and degenerative lumbar dise disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Waddell" 1 => "J.N.A. Gibson" 2 => "I. Grant" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Neck and back pain. The scientific evidence of causes, diagnosis and treatment." "paginaInicial" => "305" "paginaFinal" => "326" "serieFecha" => "2000" ] ] ] ] ] ] 74 => array:3 [ "identificador" => "bib75" "etiqueta" => "75." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-operative treatment of chronic lowback pain: specific back muscular strength training versus improvement of physical fitness" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Weinhardt" 1 => "K.D. Heller" 2 => "L. Weh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2001-19229" "Revista" => array:6 [ "tituloSerie" => "Z Orthop Ihre Grenzgeb" "fecha" => "2001" "volumen" => "139" "paginaInicial" => "490" "paginaFinal" => "495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11753768" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/11301473/0000001600000002/v1_201305151236/S1130147305704206/v1_201305151236/es/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001600000002/v1_201305151236/S1130147305704206/v1_201305151236/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147305704206?idApp=UINPBA00004B" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Diciembre | 0 | 2 | 2 |
| 2023 Marzo | 0 | 2 | 2 |
| 2022 Enero | 0 | 2 | 2 |
| 2021 Diciembre | 0 | 2 | 2 |
| 2021 Octubre | 1 | 2 | 3 |
| 2018 Febrero | 11 | 8 | 19 |
| 2018 Enero | 17 | 9 | 26 |
| 2017 Diciembre | 13 | 19 | 32 |
| 2017 Noviembre | 39 | 20 | 59 |
| 2017 Octubre | 9 | 11 | 20 |
| 2017 Septiembre | 15 | 13 | 28 |
| 2017 Agosto | 8 | 18 | 26 |
| 2017 Julio | 11 | 8 | 19 |
| 2017 Junio | 23 | 23 | 46 |
| 2017 Mayo | 28 | 20 | 48 |
| 2017 Abril | 20 | 9 | 29 |
| 2017 Marzo | 13 | 18 | 31 |
| 2017 Febrero | 7 | 2 | 9 |
| 2017 Enero | 8 | 11 | 19 |
| 2016 Diciembre | 21 | 19 | 40 |
| 2016 Noviembre | 15 | 19 | 34 |
| 2016 Octubre | 29 | 35 | 64 |
| 2016 Septiembre | 41 | 37 | 78 |
| 2016 Agosto | 53 | 32 | 85 |
| 2016 Julio | 29 | 27 | 56 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Octubre | 1 | 0 | 1 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Junio | 16 | 15 | 31 |
| 2015 Mayo | 25 | 28 | 53 |
| 2015 Abril | 16 | 18 | 34 |
| 2015 Marzo | 16 | 23 | 39 |
| 2015 Febrero | 21 | 23 | 44 |
| 2015 Enero | 18 | 25 | 43 |
| 2014 Diciembre | 19 | 26 | 45 |
| 2014 Noviembre | 15 | 16 | 31 |
| 2014 Octubre | 20 | 26 | 46 |
| 2014 Septiembre | 20 | 28 | 48 |
| 2014 Agosto | 18 | 33 | 51 |
| 2014 Julio | 16 | 21 | 37 |
| 2014 Junio | 33 | 23 | 56 |
| 2014 Mayo | 25 | 29 | 54 |
| 2014 Abril | 31 | 17 | 48 |
| 2014 Marzo | 26 | 32 | 58 |
| 2014 Febrero | 15 | 36 | 51 |
| 2014 Enero | 21 | 26 | 47 |
| 2013 Diciembre | 21 | 30 | 51 |
| 2013 Noviembre | 22 | 42 | 64 |
| 2013 Octubre | 22 | 82 | 104 |
| 2013 Septiembre | 26 | 32 | 58 |
| 2013 Agosto | 36 | 37 | 73 |
| 2013 Julio | 32 | 34 | 66 |
| 2013 Junio | 22 | 32 | 54 |
| 2013 Mayo | 21 | 52 | 73 |
| 2013 Abril | 21 | 25 | 46 |
| 2013 Marzo | 22 | 45 | 67 |
| 2013 Febrero | 14 | 22 | 36 |
| 2013 Enero | 19 | 12 | 31 |
| 2012 Diciembre | 17 | 25 | 42 |
| 2012 Noviembre | 1 | 10 | 11 |
| 2012 Octubre | 0 | 1 | 1 |
| 2012 Septiembre | 0 | 1 | 1 |
| 2012 Enero | 11 | 0 | 11 |
Mostrar todo
