Infusión intratecal de baclofeno en el tratamiento de la espasticidad severa
G. García-March, M.aJ. Sánchez-Ledesma, J. Anaya, J.M. Gonçalves, J. Broseta
Servicio y Cátedra de Neurocirugía, Complejo Hospitalario y Universidad de Salamanca. Salamanca
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"apellidos" => "Baguena" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Monforte" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147390711840?idApp=UINPBA00004B" "url" => "/11301473/0000000100000005/v1_201305151000/S1130147390711840/v1_201305151000/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "titulo" => "Infusión intratecal de baclofeno en el tratamiento de la espasticidad severa" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "269" "paginaFinal" => "277" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "G. García-March, M.<span class="elsevierStyleSup">a</span>J. Sánchez-Ledesma, J. Anaya, J.M. Gonçalves, J. Broseta" "autores" => array:5 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "García-March" ] 1 => array:2 [ "nombre" => "M.<span class="elsevierStyleSup">a</span>J." "apellidos" => "Sánchez-Ledesma" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Anaya" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Gonçalves" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Broseta" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio y Cátedra de Neurocirugía, Complejo Hospitalario y Universidad de Salamanca. Salamanca" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Descriptores" "identificador" => "xpalclavsec156559" "palabras" => array:7 [ 0 => "Espasticidad" 1 => "Dolor" 2 => "Disfunción vesical neurogénica" 3 => "Espasmos" 4 => "Distonía" 5 => "Baclofeno" 6 => "Bombas programables" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec156560" "palabras" => array:7 [ 0 => "Spasticity" 1 => "Pain" 2 => "Neurogenic bladder dysfunction" 3 => "Spasms" 4 => "Dystonia" 5 => "Baclofen" 6 => "Programmable pumps" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sobre la base de estudios clínicos y experimentales previos se seleccionaron 22 pacientes con espasticidad severa resistente a la terapéutica farmacológica convencional, cuya naturaleza obedecía a una afectación medular en 17 casos, 7 por esclerosis múltiple, 8 por paraplegia postraumática y 2 por otras causas, y a una lesión encefálica difusa en 5 casos. En este grupo se valoró el efecto de la infusión intratecal de morfina y baclofeno a través de un catéter colocado en el espacio subaracnoideo conectado a un reservorio subcutáneo. Mientras la inyección de morfina no mostró ningún beneficio, la administración de baclofeno en bolos de 12,5 a 60<span class="elsevierStyleHsp" style=""></span>μg originó en 17 casos una marcada mejoría de la espasticidad y los síntomas asociados. En estos casos, tras un período de prueba de tres semanas y después de comprobar el efecto positivo del baclofeno sobre la espasticidad mediante la clínica, los estudios electroneurofisiológicos y la manometría vesical, se procedió a sustituir el reservorio por una bomba de infusión programable que permitía la administración crónica de baclofeno de forma continua, en bolos o combinando ambos modos de infusión, llegando a unas dosis diarias totales de baclofeno entre 25 y 225<span class="elsevierStyleHsp" style=""></span>μg. Después de un período de seguimiento medio de 13,5 meses, todos los casos muestran una ausencia de espasmos dolorosos, una notable mejoría en el control esfinteriano y una marcada relajación que les permite una mayor capacidad motora. En ningún caso han aparecido complicaciones o efectos secundarios.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Based on previous experimental and clinical studies, 22 patients with severe spasicity, in 17 due to spinal cord damage, resulting from multiple sclerosis in 7 cases and postraumatic paraplejia in 8 and other situations in 2, and in 5 due to traumatic central spasticity, that were resistent to all conservative attempts, were selected to a trial with morphine and baclofen intratecally administered through a catheter placed in the spinal subaracnoidal space, attached to a subcutaneous reservoir. Whereas morphine single bolus did not show any benefit, baclofen bolus of 12.5 to 60<span class="elsevierStyleHsp" style=""></span>μg revealed a marked decrease of spasticity and associated symptoms in 17 cases. In them, after checking the clinical effect during a period of 3 weeks and the changes in electroneurophysiological studies and bladder manometry, the catheter was attached to a subcutaneous programmable pump able to be refilled percutaneously that administered baclofen continuously or more often following a multistep complex program in total doses of 25 to 225<span class="elsevierStyleHsp" style=""></span>μg per day. After a mean follow-up of 13.5 months all cases showed an absence of spasms and pain, a notable bettering of sphincterian functions and a marked relaxation that improves motor ability, though not motor potency, leading to increase deambulation or movility capacities. Neither complications nor side-effects were observed.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">García-March, G.; Sánchez-Ledesma, M.<span class="elsevierStyleSup">a</span> J.; Anaya, J.; Gonçalves, J. M.; Broseta, J.: Infusión intratecal de baclofeno en el tratamiento de la espasticidad severa. Neurocirugía 1990; 1: 269–277.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High frequency cervical spinal cord stimulation in spasticity and motor disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Broseta" 1 => "G. García-march" 2 => "M.J. Sánchez-Ledesma" 3 => "J. Barberá" 4 => "J. González-Darder" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Neurochir." "fecha" => "1987" "volumen" => "39" "numero" => "Suppl" "paginaInicial" => "106" "paginaFinal" => "111" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of intrathecal baclofen administered by programmable infusion pumps in resistent spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Broseta" 1 => "F. Morales" 2 => "G. García-March" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Neurochir." "fecha" => "1989" "volumen" => "46" "numero" => "Suppl" "paginaInicial" => "39" "paginaFinal" => "45" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Choronic intrathecal baclofen in severe spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Broseta" 1 => "G. Garcia-March" 2 => "M.J. Sánchez-Ledesma" 3 => "J. Anaya" 4 => "I. Silva" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Streotact. Fund. Neurosurg." "fecha" => "1990" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Selective effect of (-) baclofen on spinal synaptic transmission in the cat" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.R. Curtis" 1 => "D. Lodge" 2 => "J.C. Bornstein" 3 => "M.J. Peet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Exp. Brain Res." "fecha" => "1981" "volumen" => "42" "paginaInicial" => "158" "paginaFinal" => "170" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6266854" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alternative approach to analgesia: Baclofen as a model compound" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.A. Cutting" 1 => "C.C. Jordan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br. J. Pharmacol." "fecha" => "1975" "volumen" => "54" "paginaInicial" => "171" "paginaFinal" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1148507" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of topical baclofen on C-fibre-evoked neuronal activity in the rat dorsal hom" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.H. Dickinson" 1 => "C.M. Brewer" 2 => "N.A. Hayes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neuroscience" "fecha" => "1985" "volumen" => "14" "paginaInicial" => "557" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2986041" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrathecal baclofen for spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Dralle" 1 => "H. Muller" 2 => "J. Zierski" 3 => "N. Klug" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Lancet" "fecha" => "1985" "volumen" => "2" "paginaInicial" => "1.003" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2574803" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Control of spasticity by implantable continuous flow morphine pump" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.L. Erickson" 1 => "J.B. Blacklock" 2 => "M.A. Michaelson" 3 => "K. Sperling" 4 => "J.N. Lo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "1985" "volumen" => "16" "paginaInicial" => "215" "paginaFinal" => "217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3838369" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Control of spasticity with intrathecal morphine sulfate" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.L. Erickson" 1 => "P. Moreno" 2 => "J.N. Lo" 3 => "J. Cameron" 4 => "M.A. Michaelson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Local-spinal therapy of spasticity" "paginaInicial" => "137" "paginaFinal" => "142" "serieFecha" => "1988" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Review of European clinical trials with baclofen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.R. Hattab" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Spasticity: disordered motor control" "paginaInicial" => "71" "paginaFinal" => "75" "serieFecha" => "1980" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reduced spinal reflexes following intrathecal baclofen in the rabbit" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.S. Lroln" 1 => "R.D. Penn" 2 => "R.L. Beissinger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Exp. Brain Res." "fecha" => "1984" "volumen" => "54" "paginaInicial" => "191" "paginaFinal" => "194" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6321222" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic cerebellar cortex stimulation for grades spastic cerebral palsy patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Y. Lazorthes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Cerebellar stimulation for spasticity and seizures" "paginaInicial" => "217" "paginaFinal" => "220" "serieFecha" => "1984" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic intrathecal administration of baclofen in treatment of severe spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Y. Lazorthes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Local-spinal Therapy of Spasticity" "paginaInicial" => "210" "paginaFinal" => "222" "serieFecha" => "1988" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spinal benzodiazepines for treatment of spasticity. Comunicación presentada al Symposium on implantable pumps" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Muller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Isle of Palms, South Caroline, September" "fecha" => "1984" "paginaInicial" => "19" "paginaFinal" => "22" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical experience with spinal morphine, midazolam and tizanidine in spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Muller" 1 => "J. Zierski" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Local-spinal therapy of spasticity" "paginaInicial" => "143" "paginaFinal" => "150" "serieFecha" => "1988" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Kontinuierliche peridurale opiatapplikation mit einer implantierten pumpe. Implantations technik und ersle ergebnisse" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H. Muller" 1 => "W. Vogelberger" 2 => "K. Aigner" 3 => "H.F. Herget" 4 => "G. Hempelmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Reg. Anaesth. (Anaesthesist)" "fecha" => "1963" "volumen" => "6" "paginaInicial" => "47" "paginaFinal" => "51" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrathecal baclofen in spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H. Muller" 1 => "J. Zierski" 2 => "D. Dralle" 3 => "O. Holfmann" 4 => "G. Michaelis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Local-spinal therapy of spasticity" "paginaInicial" => "155" "paginaFinal" => "214" "serieFecha" => "1988" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic intrathecal baclofen for severe rigdity and spasms" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.D. Penn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Local-spinal therapy of spasticity" "paginaInicial" => "151" "paginaFinal" => "153" "serieFecha" => "1988" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrathecal baclofen alleviates spinal cord spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.D. Penn" 1 => "J.S. Kroln" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Lancet" "fecha" => "1984" "volumen" => "1" "paginaInicial" => "1.078" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2567479" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Continuous intrathecal baclofen for severe spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.D. Penn" 1 => "J.S. Kroin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1985" "volumen" => "2" "paginaInicial" => "125" "paginaFinal" => "127" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2899187" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long term intrathecal baclofen infusion for treatment of spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.D. Penn" 1 => "J.S. Kroln" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/jns.1987.66.2.0181" "Revista" => array:6 [ "tituloSerie" => "J. Neurosurg." "fecha" => "1987" "volumen" => "66" "paginaInicial" => "181" "paginaFinal" => "185" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3806200" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are baclofen sensitive GABA-B receptors present on primary afferent terminals of the spinal cord?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.W. Price" 1 => "G.P. Wilkin" 2 => "M.J. Tumbull" 3 => "N.G. Bowery" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Nature" "fecha" => "1984" "volumen" => "307" "paginaInicial" => "71" "paginaFinal" => "74" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6318120" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La neurostimulation électrique thérapeutique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Siegfried" 1 => "Y. Lazhortes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Neurochirurgie, (Suppl. 1)" "fecha" => "1985" "volumen" => "31" "paginaInicial" => "1" "paginaFinal" => "118" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrathecal application of baclofen in the treatment of spasticity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Siegfried" 1 => "G.L. Rea" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Neuro-chirurg" "fecha" => "1987" "volumen" => "39" "numero" => "Suppl" "paginaInicial" => "121" "paginaFinal" => "123" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Baclofen is antinociceptive in the spinal intrathecal space of animals" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.R. Wilson" 1 => "T.L. Yaksh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur. J. Pharmacol." "fecha" => "1978" "volumen" => "51" "paginaInicial" => "323" "paginaFinal" => "330" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/581376" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/11301473/0000000100000005/v1_201305151000/S1130147390711852/v1_201305151000/es/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11301473/0000000100000005/v1_201305151000/S1130147390711852/v1_201305151000/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147390711852?idApp=UINPBA00004B" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 1 | 0 | 1 |
| 2022 Enero | 0 | 2 | 2 |
| 2019 Noviembre | 0 | 2 | 2 |
| 2018 Febrero | 10 | 21 | 31 |
| 2018 Enero | 20 | 25 | 45 |
| 2017 Diciembre | 15 | 21 | 36 |
| 2017 Noviembre | 15 | 43 | 58 |
| 2017 Octubre | 8 | 30 | 38 |
| 2017 Septiembre | 19 | 40 | 59 |
| 2017 Agosto | 17 | 21 | 38 |
| 2017 Julio | 16 | 24 | 40 |
| 2017 Junio | 19 | 12 | 31 |
| 2017 Mayo | 23 | 15 | 38 |
| 2017 Abril | 12 | 22 | 34 |
| 2017 Marzo | 7 | 55 | 62 |
| 2017 Febrero | 5 | 11 | 16 |
| 2017 Enero | 8 | 6 | 14 |
| 2016 Diciembre | 26 | 20 | 46 |
| 2016 Noviembre | 20 | 25 | 45 |
| 2016 Octubre | 26 | 24 | 50 |
| 2016 Septiembre | 43 | 39 | 82 |
| 2016 Agosto | 41 | 23 | 64 |
| 2016 Julio | 40 | 47 | 87 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 2 | 5 | 7 |
| 2015 Junio | 16 | 26 | 42 |
| 2015 Mayo | 22 | 40 | 62 |
| 2015 Abril | 22 | 35 | 57 |
| 2015 Marzo | 19 | 43 | 62 |
| 2015 Febrero | 15 | 29 | 44 |
| 2015 Enero | 14 | 24 | 38 |
| 2014 Diciembre | 14 | 40 | 54 |
| 2014 Noviembre | 18 | 38 | 56 |
| 2014 Octubre | 18 | 50 | 68 |
| 2014 Septiembre | 16 | 42 | 58 |
| 2014 Agosto | 19 | 40 | 59 |
| 2014 Julio | 13 | 32 | 45 |
| 2014 Junio | 22 | 25 | 47 |
| 2014 Mayo | 23 | 40 | 63 |
| 2014 Abril | 11 | 33 | 44 |
| 2014 Marzo | 14 | 53 | 67 |
| 2014 Febrero | 22 | 42 | 64 |
| 2014 Enero | 14 | 27 | 41 |
| 2013 Diciembre | 21 | 27 | 48 |
| 2013 Noviembre | 17 | 28 | 45 |
| 2013 Octubre | 20 | 33 | 53 |
| 2013 Septiembre | 23 | 35 | 58 |
| 2013 Agosto | 28 | 42 | 70 |
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| 2013 Mayo | 19 | 41 | 60 |
| 2013 Abril | 16 | 40 | 56 |
| 2013 Marzo | 10 | 32 | 42 |
| 2013 Febrero | 13 | 20 | 33 |
| 2013 Enero | 16 | 16 | 32 |
| 2012 Diciembre | 12 | 13 | 25 |
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