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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sobre la columna cervical alta &#40;C0-C1-C2&#41; recae m&#225;s del 60&#37; de todas las lesiones traum&#225;ticas de la columna cervical&#59; as&#237;&#44; un 4&#8211;15&#37; de todas las fracturas cervicales afectan al atlas y un 15&#8211;25&#37; al axis&#46; Hoy en d&#237;a las t&#233;cnicas de neuroimagen permiten ver las lesiones anat&#243;micas y funcionales producidas en el accidente&#44; comprender los mecanismos patomec&#225;nicos de estas lesiones&#44; establecer una correlaci&#243;n cl&#237;nico-radiol&#243;gica y funcional de la patolog&#237;a producida&#44; clasificar todas las lesiones&#44; predecir su posible comportamiento y evoluci&#243;n y establecer pautas terap&#233;uticas adecuadas&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La clasificaci&#243;n de las lesiones traum&#225;ticas de C0-C1-C2 es imprescindible para tipificar la lesi&#243;n y as&#237; definir los distintos tipos posibles de lesiones traum&#225;ticas producidas&#46; En el contexto individual de cada paciente&#44; cada tipo de lesi&#243;n nos permite elegir el proceso terap&#233;utico&#44; m&#233;dico o quir&#250;rgico&#44; m&#225;s adecuado&#46; De ello resulta una clara indicaci&#243;n terap&#233;utica correcta para cada caso concreto&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En los casos con indicaci&#243;n quir&#250;rgica&#44; la finalidad de la intervenci&#243;n ser&#225;&#58; a&#41; liberar elementos radiculomedulares atrapados mediante discectom&#237;as&#44; corpectom&#237;as&#44; laminectom&#237;as&#44; evacuaci&#243;n de colecciones o ampliaci&#243;n de espacios&#59; b&#41; alinear segmentos vertebrales mediante tracci&#243;n con comp&#225;s&#44; o con halo&#44; manipulaci&#243;n o cirug&#237;a&#59; c&#41; estabilizar elementos vertebrales con t&#233;cnicas quir&#250;rgicas v&#237;a anterior&#44; posterior o con dobles abordajes 360&#176; surgery&#59; d&#41; detener la evoluci&#243;n cl&#237;nico-radiol&#243;gica y&#44; e&#41; permitir la m&#225;xima recuperaci&#243;n funcional&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A pesar de que en los &#250;ltimos a&#241;os todas las posibles lesiones traum&#225;ticas del segmento occipitoatloaxoideo est&#225;n correctamente clasificadas y tipificadas&#44; las pautas de tratamiento no son uniformes ni todav&#237;a aceptadas o aplicadas de forma un&#225;nime&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En este trabajo se presenta la experiencia del autor en el manejo de este tipo de lesiones traum&#225;ticas&#46; Se analizan 286 lesiones del segmento C0-C1-C2 y se correlaciona su clasificaci&#243;n y tipolog&#237;a con las pautas de tratamiento establecidas&#46; Poner orden en la selecci&#243;n de casos para una indicaci&#243;n terap&#233;utica concreta&#44; correcta y eficaz de la instrumentaci&#243;n cervical junto a una ejecuci&#243;n terap&#233;utica meticulosa y precisa&#44; es un reto actual de los cirujanos que tratamos a estos pacientes&#46;</p>"
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        "titulo" => "Summary"
        "resumen" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Around 60&#37; of all cervical fractures occur in the high cervical segment &#40;C0-C1-C2&#41;&#59; 4&#8211;15&#37; occurs in C1&#44; and between 15&#8211;25&#37; in the axis&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Nowadays&#44; with high resolution imaging&#44; we can see both anatomic and functional aspects of the fractures&#44; as well as understand the mechanisms of injury&#46; This can also allow us to study the evolution of the soft tissue lesions and fractures&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The classification of traumatic injuries in C0-C1-C2 is basic in order to understand the mechanism of injury and natural history of these lesions&#46; This also allow us to choose the correct or most adequate form of treatment&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">In the cases where surgery is indicated we must&#58; a&#41; release of the cord or nerves&#44; using standard techniques such as laminectomy&#44; discectomy or corpectomy&#59; b&#41; align vertebral segments using traction&#44; halo vest or surgery&#59; c&#41; estabilize the vertebral segments&#44; using anterior&#44; posterior or 360&#176; surgical approaches&#59; d&#41; stop the natural history of disease and e&#41; allow maximal functional recovery&#46;</p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Although there are good classifications that typify the fractures in the C0-C1-C2 segments&#44; there are not clear or standard treatments for them&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">This paper shows the personal experience of the author in the management of this type of fractures&#46; The 286 patients with lesions in the high cervical segment C0-C1-C2 have been treated according to the classifications and recommendations already established in the literature&#46; Selection of this cases and appropiate surgical approach is still a challenge for surgeons who deal with this problems&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Mart&#237;n-Ferrer&#44; S&#46;&#58; Traumatismos de la columna cervical alta&#58; Clasificaci&#243;n tipol&#243;gica&#44; indicaciones terap&#233;uticas y abordajes quir&#250;rgicos &#40;a prop&#243;sito de 286 casos&#41;&#46; Neurocirug&#237;a 2006&#59; 17&#58; 391&#8211;419&#46;</p>"
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Teléfono
Llamadas desde España
932 415 960
Llamadas desde el extranjero
+34 932 415 960
Horario de 9 a 18h. excepto los meses de julio y agosto que será de 9 a 15h.
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Neurocirugía
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