NEUROCIRUGIA DE BAJO COSTO Y ALTO RENDIMIENTO PARA EL TRATAMIENTO DE DISCOPATIA CERVICAL DEGENERATIVA
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Gac Med Bol
Abstract
La discopatía degenerativa forma parte del proceso natural de envejecimiento. A medida que envejecemos, los discos intervertebrales pierden las características de flexibilidad, elasticidad y amortiguación. Los ligamentos que rodean al disco, que forman el anillo fibroso, se vuelven quebradizos y se desgarran con más facilidad, el núcleo pulposo, empieza a secarse y encogerse. Las opciones de tratamiento, puede incluir opciones no quirúrgicas tales como antiinflamatorios no esteroides, ejercicio y fisioterapia. La cirugía de la columna vertebral se considera solamente cuando los tratamientos conservadores no han logrado aliviar los síntomas. Esta es una nueva técnica para el tratamiento de la discopatia cervical degenerativa. El procedimiento consiste en sacar injerto de hueso del paciente, proveniente de la cresta ilíaca, el mismo que esté constituido por una parte cortical y una parte central esponjosa. La cortical, por ser más fuerte, mantiene el espacio abierto, mientras que la esponjosa permite una integración y una revascularización rápida del injerto que no se mueve y se integra rápidamente a las vértebras superior e inferior. Este tipo de injertos puede colocarse a nivel de columna cervical, donde es más frecuente la hernia de disco cervical a la altura de C4, C5, C6 y C7; pero también puede usarse en caso de traumatismo raquimedular. Con este trabajo queremos mostrar que la cirugía vía anterior para el tratamiento de la hernia discal cervical es la más adecuada, además la dicoidectomía por vía anterior, con injerto homólogo de cresta ilíaca sin instrumentación, sigue siendo el mejor tratamiento, en nuestro medio.
The degenerative discopathy it is part of the natural process of aging. As we age, the disks intervertebral lose the characteristics of flexibility, elasticity and subduing. The ligaments that surround to the disk that they form the fibrous ring, become brittle and they are torn with more easiness, the nucleus pulpous, begins to dry off and to shrink. The treatment options, includes such non surgical options as anti-inflammatory non steroids, exercise and physiotherapy. The surgery of the spine is only considered when the conservative treatments have not been able to alleviate the symptoms. This is a new technique for the treatment of the degenerative cervical discopathy. The procedure consists on taking out implant of the patient's bone, coming from the crest ileac, the same one that is constituted on one hand cortical and a spongy central part. The cortical one, to be stronger, maintains the open space, while the spongy one allows integration and a quick revascularization of the implant that doesn't move and is integrated quickly to the vertebras superior and inferior. This type of implants can be placed at level of cervical column, where it is more frequent the hernia of cervical disk to the height of C4, C5, C6 and C7; but it can also be used in the event of traumatism raquimedular. With this work we want to show that the surgery via previous for the treatment of the hernia cervical discal is the most appropriate, also the discoidectomy for via previous, with homologous implant of crest ileac without instrumentation, it continues being the best treatment, in our means.
The degenerative discopathy it is part of the natural process of aging. As we age, the disks intervertebral lose the characteristics of flexibility, elasticity and subduing. The ligaments that surround to the disk that they form the fibrous ring, become brittle and they are torn with more easiness, the nucleus pulpous, begins to dry off and to shrink. The treatment options, includes such non surgical options as anti-inflammatory non steroids, exercise and physiotherapy. The surgery of the spine is only considered when the conservative treatments have not been able to alleviate the symptoms. This is a new technique for the treatment of the degenerative cervical discopathy. The procedure consists on taking out implant of the patient's bone, coming from the crest ileac, the same one that is constituted on one hand cortical and a spongy central part. The cortical one, to be stronger, maintains the open space, while the spongy one allows integration and a quick revascularization of the implant that doesn't move and is integrated quickly to the vertebras superior and inferior. This type of implants can be placed at level of cervical column, where it is more frequent the hernia of cervical disk to the height of C4, C5, C6 and C7; but it can also be used in the event of traumatism raquimedular. With this work we want to show that the surgery via previous for the treatment of the hernia cervical discal is the most appropriate, also the discoidectomy for via previous, with homologous implant of crest ileac without instrumentation, it continues being the best treatment, in our means.
Description
Vol. 32, No. 2