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ABSTRACT: 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 fusion by means of the Cloward procedure.
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 fusion 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 = 0.008), vascular risk factors (p = 0.031), duration of symptoms (p = 0.002), pre-surgical neurological status (p < 0.001), neuroradiological diagnosis (p = 0.014), intra-medullary high signal intensity changes in T2-weighted images (p = 0.008), prolongation of the central somato-sensory or motor conduction times (p = 0.004) and neurologic complications (p = 0.012)
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 operate.
Neurocirugia (Asturias, Spain) 07/2005; 16(3):235-55. · 0.54 Impact Factor
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ABSTRACT: We performed a retrospective analysis of complications and radiological results in 167 patients surgically treated, for discal or spondylotic disease of the cervical spine, with Cloward procedure. Using uni and multivariate analysis, we tried to identify risk factors that might be correlated with surgical complications or radiological results.
Surgical treatment was indicated for cervical radiculopathy in 68% of the patients and for myelopathy or radiculomyelopathy in the remaining 32%. The pathologic disease responsible of the symptomatology was soft disk herniation in 59% of the cases and spondylotic changes in 41%. The patients that underwent surgery because of myelopathy were one decade older, had a longer symptomatic period and presented multi-segmentary spondylotic disease with higher frequency than patients affected of radiculopathy. The most common segments operated were CS-C6 (44.3%) and C6-C7 (30.5%). Surgical mortality was 0.6% and morbidity 29.3%. Most of the complications were transient, although 4.8% of the patients developed permanent neurological deterioration.
Complications were most commonly seen in the group of the patients undergoing surgery because of long-lasting myelopathy with multi-segmentary spondylotic disease, in those with vascular risk factors and in those operated of more than one segment. Surgeon anatomic knowledge and experience are critical for diminishing such complications. Non-union rate was 9.6%, and another 9.6% of the patients developed post-surgical kyphosis. Both factors correlated with the need of re-operation.
Neurocirugia (Asturias, Spain) 09/2002; 13(4):265-84. · 0.54 Impact Factor
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ABSTRACT: The authors report a case of cystic choroid plexus papilloma that originated in the posterior fossa. No connection with the ventricular system was found intraoperatively. Magnetic resonance (MR) and computerized tomography imaging did not furnish a diagnosis, but findings of pathological examinations were consistent with those of choroid plexus papilloma. The authors describe the different appearances of the tumor on MR images and discuss the differential diagnosis with other tumors of the posterior fossa.
Journal of Neurosurgery 06/2000; 92(5):870-2. · 2.96 Impact Factor
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ABSTRACT: We present the epidemiology and the outcome of the patients younger than 15 years-old who were admitted to our hospital during 1986 with the diagnosis of head injury. One hundred and fifty-five met the required inclusion criteria, this offers an incidence of head injury in children of 139/100,000. The boy/girl ratio was 2.1/1. The commonest causes were traffic accidents (45%), mainly those knocked down or on bicycles, and falls (41%). According to the Glasgow Coma Scale 88.5% of the head injuries were slight, only 11.5% being moderate or severe. The outcome was good in 97%. There were two intrahospital deaths, that happened in the 8 patients with severe head injury, giving a mortality rate of 25% for this group; and 5 deaths out of hospital. Thus, the global mortality secondary to head injury for children was 6.3/100,000 and year. These data show: a) the sanitary importance of the head injury in children; b) the necessity of a separate study of the head injury in children since the precipitating causes and the clinical outcome are specific; and c) the shortcomings in the urgent out of hospital medical attention, as indicates an out of hospital mortality rate of 71% which is well above that of other developed countries.
Neurologia (Barcelona, Spain) 06/1990; 5(5):155-9. · 0.79 Impact Factor
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Revista Clínica Española 04/1982; 164(6):359-62. · 2.01 Impact Factor
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Revista Clínica Española 03/1982; 164(3):211-3. · 2.01 Impact Factor
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Revista Clínica Española 03/1980; 156(3):173-8. · 2.01 Impact Factor
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ABSTRACT: We present the results of a cooperative study of 15 cases of suprasellar dysgerminomas (ectopic pinealomas) and a review of cases of the literature with histological confirmation. In all the cases, histological similarities to the germinomas which appear extracerebrally, particularly testicular seminomas, were observed. We were unable to find in the sellar region tumors of true pineal histology and tend therefore to confirm the germinal origin of these neoplasms. From a clinical point of view, we define a syndrome that these tumors produce, consisting of diabetes insipidus as the first sign, visual impairment and endocrine disturbances, with few or no radiological signs in plain studies.
Child's brain 02/1979; 5(6):505-12.
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Journal of Neurosurgery 12/1978; 49(5):753-55. · 2.96 Impact Factor
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Revista Clínica Española 08/1978; 150(1-2):99-102. · 2.01 Impact Factor
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ABSTRACT: 3 cases of pyocephalus (ventricular empyema) in newborn children are described and 16 cases from the literature are analyzed. Half of the previously published cases of pyocephalus are secondary to cerebral abscesses. Neuroradiological findings and especially the necroscopic study of a case demonstrated the existence of membranous blockages inside the ventricles which may make the circulation of CSF impossible. Our treatment of choice consists of repeated punctures and evacuations of purulent content and topic as well as parenteral administration of antibiotics. Further CSF derivative measures are almost always necessary. By these means, we believe the high mortality of these cases could be lowered.
Child's brain 02/1978; 4(3):161-7.
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Revista Clínica Española 02/1974; 132(1):59-64. · 2.01 Impact Factor
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ABSTRACT: We present the results of a cooperative study of 15 cases of suprasellar dysgerminomas (ectopic pinealomas) and a review of cases of the literature with histological confirmation. In all the cases, histological similarities to the germinomas which appear extracerebrally, particularly testicular seminomas, were observed. We were unable to find in the sellar region tumors of true pineal histology and tend therefore to confirm the germinal origin of these neoplasms. From a clinical point of view, we define a syndrome that these tumors produce, consisting of diabetes insipidus as the first sign, visual impairment and endocrine disturbances, with few or no radiological signs in plain studies.
Pediatric Neurosurgery 08/1970; 5(6):505-512. · 0.70 Impact Factor
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Archivos de neurobiologiá 47(3):115-8.
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Neurochirurgie 20(5):409-20. · 0.34 Impact Factor
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ABSTRACT: Mielopatía cervical: análisis retrospectivo de los resultados quirúrgicos de 54 pacientes tratados mediante discectomía y fusión intersomática por vía anterior
Neurocirugía: Organo oficial de la Sociedad Española de Neurocirugía, ISSN 1130-1473, Vol. 16, Nº. 3, 2005, pags. 235-255.
