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Lobato, J.F. Alen, A. Perez-Nuñez, R. Alday, P.A. Gómez, B. Pascual, A. Lagares, P. Miranda, I. Arrese, A. Kaen" "autores" => array:10 [ 0 => array:2 [ "nombre" => "R.D." "apellidos" => "Lobato" ] 1 => array:2 [ "nombre" => "J.F." "apellidos" => "Alen" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Perez-Nuñez" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Alday" ] 4 => array:2 [ "nombre" => "P.A." "apellidos" => "Gómez" ] 5 => array:2 [ "nombre" => "B." "apellidos" => "Pascual" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Lagares" ] 7 => array:2 [ "nombre" => "P." "apellidos" => "Miranda" ] 8 => array:2 [ "nombre" => "I." "apellidos" => "Arrese" ] 9 => array:2 [ "nombre" => "A." "apellidos" => "Kaen" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113014730570405X?idApp=UINPBA00004B" "url" => "/11301473/0000001600000003/v1_201305151239/S113014730570405X/v1_201305151239/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "titulo" => "Mielopatía cervical: análisis retrospectivo de los resultados quirúrgicos de 54 pacientes tratados mediante discectomía y fusión intersomática por vía anterior" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "235" "paginaFinal" => "255" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "R. Martín, J.R. Carda, F. Montiaga, J.I. Pinto, F. Sanz, B. Paternina, F. Trigueros, J.M. Izquierdo, A. Vázquez-Barquero" "autores" => array:9 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.R." "apellidos" => "Carda" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Montiaga" ] 3 => array:2 [ "nombre" => "J.I." "apellidos" => "Pinto" ] 4 => array:2 [ "nombre" => "F." "apellidos" => "Sanz" ] 5 => array:2 [ "nombre" => "B." "apellidos" => "Paternina" ] 6 => array:2 [ "nombre" => "F." "apellidos" => "Trigueros" ] 7 => array:2 [ "nombre" => "J.M." "apellidos" => "Izquierdo" ] 8 => array:2 [ "nombre" => "A." "apellidos" => "Vázquez-Barquero" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital Universitario Marqués de Valdecilla. Santander" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital Universitario “Marqués de Valdecilla”. Avenida Marqués de Valdecilla s/n. 39008 Santander." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Cervical myelopathy: Retrospective analysis of surgical results in 53 cases treated by anterior cervical discectomy and interbody fusión" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-10-01" "fechaAceptado" => "2003-11-12" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158883" "palabras" => array:5 [ 0 => "Artrodesis intersomática" 1 => "Discectomía cervical" 2 => "Hernia discal cervical" 3 => "Mielopatía cervical" 4 => "Radiculopatía cervical" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec158884" "palabras" => array:4 [ 0 => "Cervical discectomy" 1 => "Cervical disc herniation" 2 => "Cervical myelopathy" 3 => "Interbody fusión" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se analiza de forma retrospectiva el resultado clínico de una serie consecutiva de 53 pacientes afectos de mielopatía o mielorradiculopatía cervical que fueron intervenidos mediante discectomía cervical y artrodesis por vía anterior utilizando la técnica de Cloward, con un seguimiento medio de 3 años.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El 64.2% de los pacientes se benefició del tratamiento quirúrgico, mejorando en uno o más grados en la escala de Nurick. No se produjo mortalidad, aunque apareció deterioro neurológico en el 9.4% de los casos. Se objetivó una correcta fusión de los segmentos intervenidos en el 92.5% de las cirugías, desarrollando un 9.4% de los enfermos cifosis postquirúrgica. En el análisis multivariante se identificaron como factores relacionados con el resultado clínico: edad (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.008), presencia de factores de riesgo vascular (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.031), duración de la clínica (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.002), estado neurológico prequirúrgico (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001), diagnóstico neurorradiológico (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.014), presencia de hiperseñal intramedular en las secuencias de resonancia magnética potenciadas en T2 (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.008), alteración de la conducción medular en el estudio neurofisiológico (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.004) y desarrollo de complicaciones quirúrgicas (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.012).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dadas las discrepancias existentes en la actualidad, la optimización del tratamiento de estos pacientes pasa por una valoración individualizada, y por la realización de estudios prospectivos y randomizados que respondan a las preguntas cuándo y cómo operar.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">We perform a retrospective analysis of clinical results in 53 consecutive patients surgically treated for cervical myelopathy or myelo-radiculopathy with anterior cervical discectomy and interbody fusión by means of the Cloward procedure.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">64.2% of the patients had good outcome as measured by the improvement in one or more grades in the Nurick's scale. No mortality related to the surgical procedure was noted, although 9.4% of the cases suffered neurological deterioration. Correct fusión was achieved in 92.5% of the patients, with a rate of post-surgical kyphosis of 9.4%. Multivariate analysis identified as factors related to the clinical outcome: age (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.008), vascular risk factors (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.031), duration of symptoms (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.002), pre-surgical neurological status (p<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.001), neuroradiological diagnosis (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.014), intramedullary high signal intensity changes in T2-weighted images (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.008), prolongation of the central somatosensory or motor conduction times (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.004) and neurologic complications (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.012)</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Treatment optimisation of the patient suffering cervical spondylotic myelopathy requires individualised evaluation. Prospective randomised studies are needed to answer the questions when and how to opérate.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Martín, R.; Carda, J.F.; Montiaga, F.; Pinto, J.I.; Sanz, F.; Paternina, B.; Trigueros, F.; Izquierdo, J.M.; Vázquez-Barquero, A.: Mielopatía cervical: análisis retrospectivo de los resultados quirúrgicos de 54 pacientes tratados mediante discectomía y fusión intersomática por vía anterior. Neurocirugía 2005; 16: 235–255.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:76 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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