Inestabilidad segmentaria lumbar degenerativa
Degenerative lumbar segmental instability
J. Fandiño, M. García-Abeledo
Unidad de Neurocirugía. Policlínico de Lugo
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Hernández Vicente, P. Díaz Cascajo, A. Maillo Sánchez, J.A. Martín, F. Morales Ramos" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Hernández Vicente" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Díaz Cascajo" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Maillo Sánchez" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Martín" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Morales Ramos" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147398710188?idApp=UINPBA00004B" "url" => "/11301473/0000000900000002/v1_201305151509/S1130147398710188/v1_201305151509/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Inestabilidad segmentaria lumbar degenerativa" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "135" "paginaFinal" => "140" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "J. Fandiño, M. García-Abeledo" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Fandiño" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "García-Abeledo" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Neurocirugía. Policlínico de Lugo" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Degenerative lumbar segmental instability" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec163307" "palabras" => array:4 [ 0 => "Inestabilidad" 1 => "Segmentaria" 2 => "Lumbar" 3 => "Biomecánica" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec163306" "palabras" => array:4 [ 0 => "Instability" 1 => "Segmental" 2 => "Lumbar" 3 => "Biomechanical" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La inestabilidad espinal es una de las causas más frecuentes de dolor lumbar, y sin embargo no ha sido plenamente definida y no muy bien comprendida. En general se considera que un segmento lumbar es inestable cuando genera movimientos anormales que a la larga conducen a una restricción en los movimientos fisiológicos vertebrales para compensar la aparición del dolor.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Para que la columna se defienda de la aparición de la inestabilidad pone en marcha tres subsistemas, musculoesquelético pasivo, activo y neural, pero la disfunción aguda o crónica degenerativa de alguno de ellos provoca una disfunción vertebral. La inestabilidad debe de ser detectada clínicamente durante el examen médico y refrendada por un concienzudo y dinámico examen radiológico. Sobre estas bases se procederá al tratamiento específico de cada caso, de forma individualizada, bien conservadoramente o con cirugía. Pero el número de fallos es mayor de lo deseable, lo que significa que la plena comprensión está por llegar.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En esta revisión se analizan los criterios de diversos autores para establecer una más uniforme aproximación al diagnóstico clínico, radiológico, así como la indicación del tratamiento.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Spinal instability is considered to be one of the most important causes of low back pain but it is poorly defined and not well understood. A lumbar motion segment is considered to be unstable when it exhibits abnormal movement. The spinal stabilizing system is conceptualized as consisting of three subsystems; passive musculoskeletal, active musculoskeletal and neural subsystems. Chronic dysfunction of the components of any of the subsystems or increased functional demands on them may lead to adaptive changes. The instability can be detected during the physical examination by a trained observer and by radiographic studies with dynamic views obtained in the frontal and lateral projections identifying unstable states.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The majority of patients with spinal instability unresponsive to conservative management require only decompressive surgery or fusion.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In this review we analyze the opinions related with the management of segmental instability of the lumbar spine and comment on the diagnosis criteria used by different authors.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Fandiño, J.; García-Abeledo, M.: Inestabilidad segmentaria lumbar degenerativa. Neurocirugía 1998; 9: 135–140.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.B.J. Andersson" 1 => "M.H. Pope" 2 => "J.W. Frymoyer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Occupational low back pain" "paginaInicial" => "101" "paginaFinal" => "114" "serieFecha" => "1982" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Junio | 1 | 1 | 2 |
| 2023 Marzo | 9 | 5 | 14 |
| 2018 Marzo | 4 | 2 | 6 |
| 2018 Febrero | 51 | 20 | 71 |
| 2018 Enero | 48 | 40 | 88 |
| 2017 Diciembre | 52 | 49 | 101 |
| 2017 Noviembre | 97 | 83 | 180 |
| 2017 Octubre | 42 | 55 | 97 |
| 2017 Septiembre | 68 | 79 | 147 |
| 2017 Agosto | 65 | 62 | 127 |
| 2017 Julio | 46 | 57 | 103 |
| 2017 Junio | 87 | 91 | 178 |
| 2017 Mayo | 72 | 58 | 130 |
| 2017 Abril | 54 | 85 | 139 |
| 2017 Marzo | 72 | 123 | 195 |
| 2017 Febrero | 107 | 131 | 238 |
| 2017 Enero | 41 | 115 | 156 |
| 2016 Diciembre | 53 | 79 | 132 |
| 2016 Noviembre | 104 | 101 | 205 |
| 2016 Octubre | 63 | 109 | 172 |
| 2016 Septiembre | 164 | 211 | 375 |
| 2016 Agosto | 252 | 251 | 503 |
| 2016 Julio | 101 | 157 | 258 |
| 2015 Diciembre | 4 | 0 | 4 |
| 2015 Julio | 6 | 12 | 18 |
| 2015 Junio | 38 | 125 | 163 |
| 2015 Mayo | 36 | 120 | 156 |
| 2015 Abril | 35 | 120 | 155 |
| 2015 Marzo | 31 | 153 | 184 |
| 2015 Febrero | 20 | 138 | 158 |
| 2015 Enero | 24 | 142 | 166 |
| 2014 Diciembre | 22 | 99 | 121 |
| 2014 Noviembre | 24 | 148 | 172 |
| 2014 Octubre | 33 | 136 | 169 |
| 2014 Septiembre | 23 | 147 | 170 |
| 2014 Agosto | 28 | 160 | 188 |
| 2014 Julio | 20 | 123 | 143 |
| 2014 Junio | 43 | 122 | 165 |
| 2014 Mayo | 38 | 166 | 204 |
| 2014 Abril | 27 | 104 | 131 |
| 2014 Marzo | 27 | 120 | 147 |
| 2014 Febrero | 23 | 104 | 127 |
| 2014 Enero | 36 | 102 | 138 |
| 2013 Diciembre | 26 | 64 | 90 |
| 2013 Noviembre | 25 | 78 | 103 |
| 2013 Octubre | 37 | 93 | 130 |
| 2013 Septiembre | 29 | 129 | 158 |
| 2013 Agosto | 27 | 133 | 160 |
| 2013 Julio | 33 | 126 | 159 |
| 2013 Junio | 26 | 133 | 159 |
| 2013 Mayo | 23 | 150 | 173 |
| 2013 Abril | 21 | 138 | 159 |
| 2013 Marzo | 24 | 105 | 129 |
| 2013 Febrero | 11 | 58 | 69 |
| 2013 Enero | 23 | 52 | 75 |
| 2012 Diciembre | 8 | 43 | 51 |
| 2012 Noviembre | 2 | 22 | 24 |
| 2012 Octubre | 0 | 6 | 6 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 11 | 0 | 11 |
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