Ítem
Acceso Abierto

Tratamiento de fracturas atlantoaxiales combinadas en el adulto mayor empleando instrumentación posterior tornillo-barra C1-C2

dc.contributor.advisorTorres, Jorge
dc.creatorVergara-Garcia, David
dc.creatorBuriticá, José L.
dc.creatorTorres, Jorge
dc.creatorLaverde, Leonardo
dc.creator.degreeEspecialista en Neurocirugíaspa
dc.creator.degreetypeFull timespa
dc.date.accessioned2020-07-17T00:54:59Z
dc.date.available2020-07-17T00:54:59Z
dc.date.created2020-07-03
dc.descriptionIntroducción: Dado que la instrumentación posterior tornillo-barra C1-C2 ha demostrado tener buenos resultados postoperatorios en diferentes tipos de patologías con inestabilidad atlantoaxial independiente de la edad, es razonable pensar en su potencial aplicabilidad en el escenario de las fracturas atlantoaxiales combinadas en pacientes adultos mayores, para quienes el manejo quirúrgico ha demostrado ser beneficioso. Objetivo: Realizar una descripción retrospectiva de los resultados postoperatorios obtenidos en pacientes adultos mayores con fracturas atlantoaxiales combinadas llevados a manejo quirúrgico con instrumentación posterior tornillo-barra C1-C2. Materiales y Métodos: Se realizó revisión de las historias clínicas de pacientes mayores de 65 años admitidos a dos hospitales de la ciudad de Bogotá DC entre enero de 2016 hasta enero de 2017, diagnosticados con fracturas traumáticas agudas combinadas del atlas y del axis y llevados a instrumentación posterior C1-C2 con constructos tornillo-barra. De la historia clínica se tomaron datos demográficos, clínicos, tipos de fractura, estado neurológico, estado de dolor, estado de fusión ósea, entre otros. Resultados: Se obtuvieron siete pacientes masculinos, con edad promedio 72,3 años. Ninguno presentó complicaciones perioperatorias o deterioro neurológico postoperatorio. Se evidenció fusión ósea y estabilidad del constructo en el 100% de los pacientes al año postoperatorio, con resolución completa del dolor cervical en 5 individuos, y parcial en los dos restantes. Conclusiones: La instrumentación posterior con constructos tornillo-barra C1-C2 es una excelente opción para el manejo quirúrgico de pacientes adultos mayores con fracturas atlantoaxiales combinadas dada su baja tasa de complicaciones y alta tasa de fusión ósea.spa
dc.description.abstractIntroduction: Since C1-C2 posterior screw-rod instrumentation has shown good postoperative results in different types of pathologies with atlantoaxial instability independent of age, it is reasonable to think about its potential applicability in the scenario of combined atlantoaxial fractures in elderly patients, for whom surgical management has proven beneficial. Objective: To perform a retrospective description of the postoperative results obtained in elderly patients with combined atlantoaxial fractures brought to surgical management with C1-C2 posterior screw-rod instrumentation. Materials and Methods: Medical records of patients older than 65 years admitted to two hospitals in the city of Bogotá DC from January 2016 to January 2017, diagnosed with combined acute traumatic fractures of the atlas and the axis, taken to later C1-C2 posterior screw-rod instrumentation were reviewed. Demographic and clinical data, type of fractures, neurological status, pain status, bone fusion status, among others, were collected. Results: Seven male patients were obtained, with an average age of 72.3 years. None presented perioperative complications or postoperative neurological deterioration. Bone fusion and stability of the construct were evidenced in 100% of the patients a year after surgery, with complete resolution of cervical pain in 5 individuals, and partial resolution in the remaining two. Conclusions: C1-C2 posterior screw-rod instrumentation is an excellent option for the surgical management of elderly patients with combined atlantoaxial fractures given its low rate of complications and high rate of bone fusion.spa
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.48713/10336_25464
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/25464
dc.language.isospaspa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de Medicinaspa
dc.publisher.programEspecialización en Neurologíaspa
dc.rightsAtribución-SinDerivadas 2.5 Colombiaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.spa
dc.rights.urihttp://creativecommons.org/licenses/by-nd/2.5/co/
dc.source.bibliographicCitationBabak Kalantar S. Fractures of the C1 and C2 Vertebrae. Semin Spine Surg [Internet]. 2013;25(1):23–35. Available from: http://dx.doi.org/10.1053/j.semss.2012.07.002spa
dc.source.bibliographicCitationSmith RM, Bhandutia AK, Jauregui JJ, Shasti M, Ludwig SC. Atlas Fractures. Diagnosis, Current Treatment Recommendations, and Implications for Elderly Patients. Clin Spine Surg [Internet]. 2018;00(00):1–7. Available from: https://doi.org/10.1097/BSD.0000000000000631spa
dc.source.bibliographicCitationRyken TC, Hadley MN, Aarabi B, Dhall SS, Gelb DE, Hurlbert RJ, et al. Management of acute combination fractures of the Atlas and Axis in Adults. Neurosurgery [Internet]. 2013;72(SUPPL.2):151–8. Available from: https://doi.org/10.1227/NEU.0b013e318276ee55spa
dc.source.bibliographicCitationDickman CA, Hadley MN, Browner C, Sonntag VK. Neurosurgical management of acute atlas-axis combination fractures. A review of 25 cases. J Neurosurg [Internet]. 1989;70(1):45–9. Available from: https://doi.org/10.3171/jns.1989.70.1.0045spa
dc.source.bibliographicCitationViswanathan VK, Subramanian S. Guidelines on the Management of Atlanto- Axial Fractures in Adults : A Short Review. Open Access J Surg [Internet]. 2017;7(3):5–8. Available from: http://dx.doi.org/10.19080/OAJS.2017.07.555711spa
dc.source.bibliographicCitationDaentzer D, Flörkemeier T. Conservative treatment of upper cervical spine injuries with the halo vest: an appropriate option for all patients independent of their age? J Neurosurg Spine [Internet]. 2009;10(6):543–50. Available from: https://doi.org/10.3171/2009.2.SPINE08484spa
dc.source.bibliographicCitationTashjian RZ, Majercik S, Biffl WL, Palumbo MA, Cioffi WG. Halo-vest immobilization increases early morbidity and mortality in elderly odontoid fractures. J Trauma - Inj Infect Crit Care [Internet]. 2006;60(1):199–203. Available from: https://doi.org/10.1097/01.ta.0000197426.72261.17spa
dc.source.bibliographicCitationWeller SJ, Malek a M, Rossitch E. Cervical spine fractures in the elderly. Surg Neurol [Internet]. 1997;47(96):274-280; discussion 280-281. Available from: https://doi.org/10.1016/S0090-3019(96)00362-Xspa
dc.source.bibliographicCitationOmeis I, Duggal N, Rubano J, Cerabona F, Abrahams J, Fink M, et al. Surgical treatment of C2 fractures in the elderly: a multicenter retrospective analysis. J Spinal Disord Tech [Internet]. 2009;22(2):91–5. Available from: https://doi.org/10.1097/BSD.0b013e3181723d1bspa
dc.source.bibliographicCitationAgrillo U, Mastronardi L. Acute combination fracture of atlas and axis: “Triple” anterior screw fixation in a 92-year-old man. Technical note. Surg Neurol [Internet]. 2006;65(1):58–62. Available from: https://doi.org/10.1016/j.surneu.2005.04.043spa
dc.source.bibliographicCitationWu AM, Wang XY, Chi YL, Xu HZ, Weng W, Huang QS, et al. Management of acute combination atlas-axis fractures with percutaneous triple anterior screw fixation in elderly patients. Orthop Traumatol Surg Res [Internet]. 2012;98(8):894–9. Available from: https://doi.org/10.1016/j.otsr.2012.09.006spa
dc.source.bibliographicCitationJosten C, Jarvers J-S, Glasmacher S, Spiegl UJ. Odontoid fractures in combination with C1 fractures in the elderly treated by combined anterior odontoid and transarticular C1/2 screw fixation. Arch Orthop Trauma Surg [Internet]. 2018;0(0):0. Available from: https://doi.org/10.1007/s00402-018-3013-yspa
dc.source.bibliographicCitation13. Harms J, Melcher RP. Posterior C1 – C2 Fusion With Polyaxial Screw and Rod Fixation. Spine (Phila Pa 1976) [Internet]. 2001;26(22):2467–71. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11707712spa
dc.source.bibliographicCitationGoel A, Laheri V. Plate and screw fixation for atlanto-axial subluxation. Acta Neurochir (Wien) [Internet]. 1994;129(1–2):47–53. Available from: https://doi.org/10.1007/s00192-016-2952-5spa
dc.source.bibliographicCitationWright NM. Posterior C2 Fixation Using Bilateral, Crossing C2 Laminar Screws. Case Series and Technical Note. J Spinal Disord Tech [Internet]. 2004;17(2):158–62. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15260101spa
dc.source.bibliographicCitationElliott RE, Tanweer O, Boah A, Morsi A, Ma T, Frempong-boadu A, et al. Outcome Comparison of Atlantoaxial Fusion With Meta-Analysis and Review of Literature. J Spinal Disord [Internet]. 2014;27(1):11–28. Available from: https://doi.org/10.1097/BSD.0b013e318277da19spa
dc.source.bibliographicCitationElliott RE, Tanweer O, Boah A, Morsi A, Ma T, Smith ML, et al. Atlantoaxial Fusion with Screw-Rod Constructs: Meta-Analysis and Review of Literature. World Neurosurg [Internet]. 2014;81(2):411–21. Available from: http://dx.doi.org/10.1016/j.wneu.2012.03.013spa
dc.source.bibliographicCitationDu JY, Aichmair A, Kueper J, Wright T, Lebl DR. Biomechanical analysis of screw constructs for atlantoaxial fixation in cadavers: a systematic review and meta-analysis. J Neurosurg Spine [Internet]. 2015;22(February):151–61. Available from: https://doi.org/10.3171/2014.10.SPINE13805spa
dc.source.bibliographicCitationElliott RE, Tanweer O, Boah A, Smith ML, Frempong-Boadu A. Comparison of safety and stability of C-2 pars and pedicle screws for atlantoaxial fusion: meta-analysis and review of the literature. J Neurosurg Spine [Internet]. 2012;17(6):577–93. Available from: http://thejns.org/doi/10.3171/2012.9.SPINE111021spa
dc.source.bibliographicCitationBransford RJ, Russo AJ, Freeborn M, Nguyen QT, Lee MJ, Chapman JR, et al. Posterior C2 instrumentation: Accuracy and complications associated with four techniques. Spine (Phila Pa 1976) [Internet]. 2011;36(14). Available from: https://doi.org/10.1097/BRS.0b013e3181fdaf06spa
dc.source.bibliographicCitationDobran M, Nasi D, Esposito DP, Iacoangeli M. Posterior Fixation with C1 Lateral Mass Screws and C2 Pars Screws for Type II Odontoid Fracture in the Elderly: Long-Term Follow-Up. World Neurosurg [Internet]. 2016;96:152–8. Available from: http://dx.doi.org/10.1016/j.wneu.2016.08.100spa
dc.source.bibliographicCitationGoel A, Cacciola F. The craniovertebral junction. 1st ed. Goel A, Cacciola F, editors. Stuttgart, Germany: Thieme; 2011. 338-356 p.spa
dc.source.bibliographicCitation23. Menendez JA, Wright NM. Techniques of Posterior C1-C2 Stabilization. Neurosurgery [Internet]. 2007;60(1):103–11. Available from: https://doi.org/10.1227/01.NEU.0000249220.50085.E4spa
dc.source.bibliographicCitationGuiot B, Fessler RG. Complex atlantoaxial fractures. J Neurosurg [Internet]. 1999;91(2 Suppl):139–43. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10505495spa
dc.source.bibliographicCitationMead LB, Millhouse PW, Krystal J, Vaccaro AR. C1 fractures: a review of diagnoses, management options, and outcomes. Curr Rev Musculoskelet Med [Internet]. 2016;9(3):255–62. Available from: http://dx.doi.org/10.1007/s12178-016-9356-5spa
dc.source.bibliographicCitationSchleicher P, Pingel A, Kandziora F. Safe management of acute cervical spine injuries. EFORT Open Rev [Internet]. 2018;3(5):347–57. Available from: https://doi.org/10.1302/2058-5241.3.170076spa
dc.source.bibliographicCitationKandziora F, Scholz M, Pingel A, Schleicher P, Yildiz U, Patrick K, et al. Treatment of Atlas Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Glob Spine J [Internet]. 2018;8(2_suppl):5S–11S. Available from: https://doi.org/10.1177/2192568217726304spa
dc.source.bibliographicCitationGonschorek O, Vordemvenne T, Blattert T, Katscher S, Schnake KJ. Treatment of Odontoid Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU). Glob Spine J [Internet]. 2018;8(2_suppl):12S–17S. Available from: https://doi.org/10.1177/2192568218768227spa
dc.source.bibliographicCitationYuan B, Zhou S, Chen X, Wang Z, Liu W, Jia L. Gallie technique versus atlantoaxial screw-rod constructs in the treatment of atlantoaxial sagittal instability: A retrospective study of 49 patients. J Orthop Surg Res [Internet]. 2017;12(1):1–8. Available from: https://doi.org/10.1186/s13018-017-0607-yspa
dc.source.bibliographicCitationHuang D, Hao D, He B, Wu Q. Posterior atlantoaxial fixation: a review of all techniques. Spine J [Internet]. 2015;15(10):2271–2281. Available from: https://doi.org/10.1016/j.spinee.2015.07.008spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectAtlantoaxialspa
dc.subjectAtlasspa
dc.subjectAxisspa
dc.subjectC1spa
dc.subjectC2spa
dc.subjectFracturaspa
dc.subjectCervicalspa
dc.subjectCombinadaspa
dc.subjectAdulyo mayorspa
dc.subject.ddcFarmacología & terapéuticaspa
dc.subject.keywordAtlantoaxialspa
dc.subject.keywordAtlasspa
dc.subject.keywordAxisspa
dc.subject.keywordC1spa
dc.subject.keywordC2spa
dc.subject.keywordCervicalspa
dc.subject.keywordCombinedspa
dc.subject.keywordFracturespa
dc.subject.keywordElderlyspa
dc.titleTratamiento de fracturas atlantoaxiales combinadas en el adulto mayor empleando instrumentación posterior tornillo-barra C1-C2spa
dc.title.TranslatedTitleTreatment of combined atlantoaxial fractures in the elderly with C1-C2 posterior screw-rod instrumentationeng
dc.typemasterThesiseng
dc.type.documentArtículospa
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
Archivos
Bloque original
Mostrando1 - 1 de 1
Cargando...
Miniatura
Nombre:
Vergara-Garcia-et-al.---Tratamiento-de-fracturas-atlantoaxiales-combinadas-en-el-adulto-mayor-empleando-instrumentacion-posteriortornillo-barra-C1-C2.pdf
Tamaño:
315.85 KB
Formato:
Adobe Portable Document Format
Descripción:
Artículo publicado en la Revista Chilena de Neurocirugía