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        "titulo" => "Related factors with the failed surgery of herniated lumbar disc"
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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La cirug&#237;a descompresiva de hernia discal es la intervenci&#243;n quir&#250;rgica m&#225;s frecuente a nivel de la columna lumbar&#46; La cirug&#237;a fallida oscila entre un 10 y un 40&#37; de los casos&#44; constituyendo el denominado S&#237;ndrome de la Cirug&#237;a Raqu&#237;dea Fracasada &#40;SCRF&#41;&#46; La reincorporaci&#243;n laboral a medio plazo tras la cirug&#237;a se sit&#250;a en torno al 70&#8211;85&#37;&#44; y existen pocos estudios que analicen la calidad de vida tras la intervenci&#243;n&#46; Los objetivos de este estudio son conocer la incidencia de cirug&#237;a fallida de hernia discal lumbar en nuestro medio&#44; identificando aquellos factores que puedan influir en su aparici&#243;n&#59; y estudiar factores ambientales como la reincorporaci&#243;n laboral y la calidad de vida a medio plazo tras esta cirug&#237;a&#44; as&#237; como su relaci&#243;n con el &#233;xito o fracaso quir&#250;rgico&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo transversal de 117 pacientes intervenidos de hernia discal lumbar durante el primer semestre del 2003 en nuestro hospital&#46; Para valorar la incidencia de cirug&#237;a fallida y factores relacionados se han recogido datos cl&#237;nicos de la Historia Cl&#237;nica de los pacientes de la muestra&#46; Y&#44; asimismo&#44; se ha entrevistado telef&#243;nicamente a 91 de ellos -los que contestaron- para valorar factores no cl&#237;nicos relacionados con el SCRF&#44; tales como reincorporaci&#243;n laboral&#44; satisfacci&#243;n con la cirug&#237;a&#44; realizaci&#243;n de tratamiento rehabilitador y calidad de vida a trav&#233;s del Cuestionario de Salud SF-36&#46; Para el an&#225;lisis de resultados se ha empleado el programa estad&#237;stico SPSS 11&#46;01&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En una muestra en la que la proporci&#243;n ente ambos sexos es de 1&#47;1 y la edad media de 45 &#91;35&#8211;54&#93; a&#241;os&#44; con una cl&#237;nica m&#225;s frecuente de ci&#225;tica derecha&#44; de m&#225;s de 6 meses de evoluci&#243;n&#44; correlacionada con el hallazgo radiol&#243;gico de hernia L5-S1&#44; un 37&#44;9&#37; ha presentado el SCRF&#46; Aunque es escaso el n&#250;mero de pacientes que en nuestra serie afrontan una reintervenci&#243;n&#44; se ha observado en ellos una incidencia del SCRF notablemente superior &#40;52&#44;2&#37;&#41; a los que se someten a una primera cirug&#237;a &#40;32&#37;&#41;&#46; Los factores cl&#237;nicos predictivos de resultados desfavorables en pacientes sometidos a primera cirug&#237;a han sido la cl&#237;nica precirug&#237;a de ci&#225;tica bilateral&#44; el hallazgo de estenosis de canal asociada a hernia discal y la comorbilidad&#59; mientras que los sociolaborales han sido pacientes sin estudios y aquellos que trabajan en los sectores de la conducci&#243;n&#44; construcci&#243;n y hosteler&#237;a&#46; La reincorporaci&#243;n laboral se produjo en el 64&#37; de los trabajadores activos previamente&#46; S&#243;lo en torno al 10&#37; se encuentran insatisfechos con la opci&#243;n quir&#250;rgica&#44; relacion&#225;ndose significativamente tanto esto como las dimensiones de funci&#243;n f&#237;sica&#44; dolor&#44; vitalidad y rol emocional en el SF-36 con el SCRF&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Uno de cada 3 pacientes intervenidos de hernia discal lumbar en nuestro medio presenta cirug&#237;a fallida&#44; reincorpor&#225;ndose laboralmente 2 de cada 3 pacientes previamente activos&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El paciente con cirug&#237;a fallida se encuentra afectado por dolor&#44; hasta el punto de repercutir y limitar las actividades del hogar y las laborales&#46; Adem&#225;s presenta frecuentemente sensaci&#243;n de cansancio o agotamiento&#44; y problemas emocionales que interfieren tanto en las actividades de la vida diaria como en el trabajo&#46;</p>"
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        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The surgery for herniated disc is the most common operation at the level of the lumbar spine&#46; The failed surgery rates range between 10&#37; and 40&#37;&#44; conforming what is known as Failed Back Surgery Syndrome &#40;FBSS&#41;&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Return to work after surgery occurs in 70&#8211;85&#37; of the cases&#46; There are a few studies analysing the quality of life after the operation&#46; The aims of this study are to know the incidence of the herniated disc lumbar failed surgery in our area&#44; identify those factors influencing its development&#44; and study behavioural parameters as the return to work and the quality of life at a middle term after surgery&#44; also its relation with the success or failure surgery&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A descriptive transversal study of 117 patients operated for herniated lumbar disc during the first six months of the year 2003 is reported&#46; In order to evaluate the incidence of failed surgery and the related factors&#44; the clinical records were retrospectively analyzed&#46; Ninety one patients were interviewed by phone using the Health Questionnaire SF-36&#44; in order to analyze the non clinical factors related to FBSS&#44; such as labour reincorporation&#44; satisfaction with surgery&#44; realization of rehabilitation treatment and quality of life after surgery&#46; For the statistical analysis of the results&#44; we used the program SPSS 11&#46;01&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">In a sample in which the proportion between both sexes was 1&#47;1&#44; and the middle age was over 45 years &#91;35&#8211;54&#93;&#44; in which the most frequent clinical symptom was right sciatica&#44; lasting more than 6 months&#44; correlated to disc herniation at L5-S1 level&#44; 37&#8217;9&#37; of the patients presented FBSS&#46; Although there were a few patients with reoperation in our study&#44; the incidence of FBSS in these patients was higher &#40;52&#44;9&#37;&#41; than in patients who suffered this surgery for first time &#40;32&#37;&#41;&#46; The predictive clinical factors of an unfavourable result in patients operated on for first time were bilateral sciatica&#44; the presence of stenosis associated to herniated disc and comorbidity factors&#46; On the other hand the sociolabor factors identified were a low culture level and those working as drivers&#44; building and service sectors&#46; Return to work occurred in the 64&#37; of the active workers before surgery&#46; Only around 10&#37; of patients were dissatisfied with surgical result and there was a significant relationship between this and the physical function&#44; pain&#44; vitality and emotional status in the SF-36 with the FBSS&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">One out of three patients operated of herniated lumbar disc in our area presented failed disc surgery and the return to work occurred in 2 out of three patients active before the operation&#46; The failed surgery patient suffers from pain&#44; that interferes and limits the labor and home activities&#46; Furthermore&#44; the patient presents frequent sensation of fatigue and exhaustion and also emotional problems that contribute to interfere with work and activities of the daily life&#46;</p>"
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