Objetivo: Determinar si existe relación significativa entre la duración del dolor preoperatorio y el tiempo para el retorno laboral en pacientes operados de hernia discal lumbar. El estudio: Estudio retrospectivo, transversal y analítico. Pacientes operados de hernia discal lumbar por microdiscectomía. La “duración del dolor preoperatorio” se integró en dos grupos: >6 y ≤6 meses de dolor hasta el momento de la cirugía. “Retorno laboral” con punto de corte 3 meses. Se utilizó SPSS, se calculó el OR. Hallazgos: Se analizó 68 pacientes. 55,9% se operaron luego de 6 meses de iniciado los síntomas, 30,9% no retornaron al trabajo a los 3 meses después de la cirugía. El OR para el no retorno al trabajo a los 3 meses fue de 3.65 (IC95%:1.14–11.5 p:0,034). Conclusiones: La duración del dolor preoperatorio y el tiempo para el retorno laboral en pacientes operados con hern...

Objetive: To determine if there is a significant relationship between the duration of preoperative pain and the time to return to work in patients undergoing surgery for lumbar disc herniation. The study: Retrospective, cross-sectional and analytical study. Patients undergoing microdiscectomy due to lumbar disc herniation. The duration of preoperative pain was divided into two groups: >6 and ≤ 6 months of pain until the time of surgery. "Return to work" with a cutoff point of 3 months. SPSS program was used, OR was calculated. Findings: 68 patients were analyzed. 55.9% were operated after 6 months of symptoms, 30.9% did not return to work at 3 months after surgery. The OR for “non-return to work at 3 months” group was 3.65 (95% CI:1.14-11.5 p:0.034). Conclusions: The duration of preoperative pain and the time to return to work, in patients undergoing surgery for lumbar disc hern...

Introduction: Calcified thoracic disc herniation are rare and their approach represents a surgical challenge when they are large and symptomatic. Extrapleural Transthoracic discectomy can be considered a safe approach to resection of the calcified disc fragment and spinal cord descompression. Clinical case: 53-year-old man with middle dorsalgia radiating to the inframammary region and progressive difficulty walking, proximal paraparesis moderate, sensory level T8 and urinary retention. The images demonstrated a large T6-7 disc herniation calcified causing severe spinal cord compression. The patient underwent T6-7 extrapleural transthoracic discectomy plus T6 partial corpectomy without fusion. The patient tolerated the procedure well without complications and postoperative imaging demonstrated descompression of spinal cord. At followup,irradiated dorsalgia, paraparesis, sensitive level an...

Introduction: Calcified thoracic disc herniation are rare and their approach represents a surgical challenge when they are large and symptomatic. Extrapleural Transthoracic discectomy can be considered a safe approach to resection of the calcified disc fragment and spinal cord descompression. Clinical case: 53-year-old man with middle dorsalgia radiating to the inframammary region and progressive difficulty walking, proximal paraparesis moderate, sensory level T8 and urinary retention. The images demonstrated a large T6-7 disc herniation calcified causing severe spinal cord compression. The patient underwent T6-7 extrapleural transthoracic discectomy plus T6 partial corpectomy without fusion. The patient tolerated the procedure well without complications and postoperative imaging demonstrated descompression of spinal cord. At followup,irradiated dorsalgia, paraparesis, sensitive level an...

Spinal tuberculosis accounts for 50 % of all cases of osteoarticular tuberculosis, causing disability (due to neurological complications) and deformity if left untreated. This disease is suspected based on the patient’s medical history, clinical manifestations and radiological findings. It is diagnosed by positive cultures for Mycobacterium tuberculosis, the histopathological characteristics of the condition and/or acid-fast bacilli (AFB)-positive smear tests. The main differential diagnosis of spinal tuberculosis is pyogenic spondylodiscitis. Magnetic resonance imaging is the appropriate imaging test to assess the neurological involvement and study the differential diagnosis of the disease. The main treatment is antituberculous chemotherapy, but surgery can be adjunctive in cases of complicated spinal tuberculosis. The decision of which treatment to implement depends on the neurologic...

Introducción: El linfoma óseo espinal es una enfermedad rara, siendo el linfoma difuso de células B grandes el subtipo más frecuente. Por lo general es una manifestación tardía de una enfermedad sistémica. Su manejo es multidisciplinario, incluyendo la cirugía, la quimioterapia y la radioterapia. Caso Clínico: Mujer de 40 años, con antecedente de infección por el virus de inmunodeficiencia humana, tuberculosis miliar monorresistente a isoniacida, con tiempo de enfermedad de 7 meses con déficit motor y sensitivo progresivo además de alteración esfinteriana. La resonancia contrastada muestra un proceso expansivo vertebral y paravertebral izquierdo que invade canal raquídeo por la forámina T2/T3 izquierda, con compresión medular. Se realiza laminectomía T2 y T3 más resección total de tumor más fijación espinal. La paciente recupera el déficit motor de manera progresiv...

Introduction: Spinal bone lymphoma is a rare disease, with diffuse large B-cell lymphoma being the most common subtype. It is usually a late manifestation of a systemic disease. Its management is multidisciplinary, including surgery, chemotherapy and radiotherapy. Clinical case: A 40-year-old woman, with human immunodeficiency virus infection, miliary tuberculosis monoresistant isoniazid, with disease period of 7 month with progressive motor and sensory deficit in addition to sphincter dysfunction. The contrasted MRI shows a left vertebral and paravertebral tumor that invades spinal canal through left T2/T3 foramina with spinal cord compression. Laminectomy T2 and T3 plus total resection of tumor plus spinal fixation is performed. The patient progressively recovered the motor deficit and began chemotherapy with a good response. Conclusion: The spinal bone lymphoma is an infrequent etiolo...

Introducción: El complejo C0-C1-C2 es responsable de la transición de la carga axial, con función biomecánica única, siendo afectada por múltiples patologías, que por lo general la literatura no las considera como un solo ítem, sino que lo desarrolla según su etiología, pero en nuestro estudio se ha considerado en 5 grupos: traumática, congénita, inflamatoria reumática, neoplásica y degenerativa. Objetivo: Determinar las características epidemiológicas, clínicas y del tratamiento en la patología cervical alta. Materiales y métodos: Se incluyeron a todos los pacientes con diagnóstico clínico radiológico de alguna patología cervical alta que hayan sido sometidos a tratamiento quirúrgico entre 2016 y 2021 en el Hospital Almenara. Se usó el test “t” de student y de chi cuadrado. Se dividió a los pacientes en alguno de los 5 grupos antes mencionados. Resultados: ...

Introduction: The C0-C1-C2 complex is responsible of axial load transition, and its biomechanical function is unique, it is affected by multiple pathological conditions; and generally speaking, the literature does not consider these conditions as a single item, it describes them according to etiology. For our study we considered five groups: trauma-related, congenital, rheumatic-inflammatory, neoplastic, and degenerative. Objective: To determine epidemiological, clinical, and therapy-related characteristics in upper cervical pathological conditions. Materials and methods: All patients with a clinical-radiological diagnosis of any upper cervical pathological condition that had undergone surgery between 2016 and 2021 in Guillermo Almenara Hospital were included. Student’s t test and chi square methods were used. Patients were divided into five groups: congenital, trauma-related, rheumati...

Introduction: The C0-C1-C2 complex is responsible of axial load transition, and its biomechanical function is unique, it is affected by multiple pathological conditions; and generally speaking, the literature does not consider these conditions as a single item, it describes them according to etiology. For our study we considered five groups: trauma-related, congenital, rheumatic-inflammatory, neoplastic, and degenerative. Objective: To determine epidemiological, clinical, and therapy-related characteristics in upper cervical pathological conditions. Materials and methods: All patients with a clinical-radiological diagnosis of any upper cervical pathological condition that had undergone surgery between 2016 and 2021 in Guillermo Almenara Hospital were included. Student’s t test and chi square methods were used. Patients were divided into five groups: congenital, trauma-related, rheumati...