Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, e... more Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, es una artrodesis muy usada que produce la consecuente limitación en la movilidad, menor soporte y poca tolerancia para el esfuerzo. Con el uso de sistemas de fijación ...
Despite of the advances in the knowledge and quality of the antimicrobial, the infections in orth... more Despite of the advances in the knowledge and quality of the antimicrobial, the infections in orthopaedic surgery are being a frequent problem. The perioperatory administration of antibiotics help to its prevention, however, the use must be doing in base to strict standards, since they don't have to be used indiscriminated form, because this can favoured the bacterial resistance, as well as the toxicity. The objective of the present work is to form a criterion of the antibiotic use like prophylactic. The antibiotic prophylaxis looking for preventing and to reduce the incidence of infections in orthopaedic in a situation of calculated risk. In order to prevent infections not only the antibiotics must be used, but besides to apply some ad-juvant measurements with tendency to decrease the risk factors, like obesity, additioned diseases like mellitus diabetes , VIH, etc. General preoperatory measurements so the reduction of the postoperatory hospital stay. The prophylaxis must be man...
It is defined as the reduction of the diameter in the spinal conduct, lateral ducts and/or of the... more It is defined as the reduction of the diameter in the spinal conduct, lateral ducts and/or of the intervertebral foramina. It can happens as a generalized process of sickness or it can be located or segmented. There are motor alterations and/or sensitives of pelvic members. Qualifying for inside of pathogenesis in primary and secondary. Degenerative type is most frequent. Metabolic changes of the Intervertebral disk cause a discal dehydratation, beginning a degenerative process meaning instability. The neurogenic withdrawal being the cardinal symptom of the sickness. It is presented in adults after 50 years old in 6%. The men frequency vary from 29 to 85%. The stenosis is most frequent in low back levels. It is manifested clinically for low back pain from several evolution years so as intermittent withdrawal that it can be confused with a vascular kind problem. Besides diskal hernia and spondylolisthesis, neoplasias and pelvic or abdominal alterations include the differential diagno...
The technique of placement of pedicle screws has gradually improved, but even misplacement observ... more The technique of placement of pedicle screws has gradually improved, but even misplacement observed in 1.2 to 20% of cases, have appeared techniques fluoroscopic, tomographic and electromagnetic navigation, which led it to 1.3 to 4.3%, but nevertheless they are expensive and complex technologies. Present technique pedicle screw placement by using templates with a modification in the art, performing tomography and reconstruction in the same surgical position and with the templates of 3 or more levels. Five cases of idiopathic scoliosis were performed, with correction and instrumentation with pedicular screws, where a three-dimensional model of the spine was performed with a tomography in a surgical position, whose images were exported to a 3D printer to reconstruct the desired trajectory of the screws in a template using cylinders resting on the inverse surface of the vertebrae. The direction of the screw was planned in the center of the pedicle and parallel to the upper platform of ...
Spine tumors are uncommon injuries affecting a low percentage of the population; however, these t... more Spine tumors are uncommon injuries affecting a low percentage of the population; however, these tumors can cause significant morbidity and may be related to mortality. They represent 15% of craniospinal tumors. The objective of this study is to determine the frequency of intradural extramedullary spine tumors treated in our Service and to report the definitive histopathological diagnosis. This was a retrospective study in a series of patients treated surgically with a diagnosis of intradural extramedullary tumor in the Spine Service of the National Rehabilitation Institute (Mexico) from 1996 to 2006. The following variables were evaluated: gender, age, tumor localization, symptomatology and type of tumor. Files of 27 patients were reviewed. There were 11 men and 16 women with an average age of 47.33 years. The main symptoms were pain and motor weakness. The most frequent localization was thoracic followed by lumbar. Histopathological diagnosis reported 12 cases of meningioma, 12 cas...
OBJETIVO: Explorar la efectividad de un conjunto de pruebas de diagnósticos, sistematizadas en ho... more OBJETIVO: Explorar la efectividad de un conjunto de pruebas de diagnósticos, sistematizadas en hoja de protocolo, para la determinación del Síndrome de Destrucción Vertebral en pacientes de nuestro servicio. MÉTODOS: Analizamos una propuesta de sistematización mediante un estudio piloto de 20 pacientes a quienes se realizaron 10 diferentes pruebas de laboratorio y gabinete, además del estudio histopatológico de biopsia percutánea. Se describieron las características demográficas y clínicas, con los resultados obtenidos mediante estadística descriptiva, media y desviación estándar para las variables cuantitativas y porcentajes para las cualitativas. RESULTADOS: Edad promedio de 53,3 años ± 16,56 años; 10 hombres y 10 mujeres. 30 vértebras afectadas en los 20 pacientes, 8 de ellos tuvieron afección de dos o más vértebras. El nivel más afectado fue el Lumbar en 18 casos, seguido por el Torácico en 12. El Mal de Pott se diagnosticó en 7 casos (35%), Osteomielitis en 4 (20%), Mieloma Múl...
Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, e... more Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, es una artrodesis muy usada que produce la consecuente limitación en la movilidad, menor soporte y poca tolerancia para el esfuerzo. Con el uso de sistemas de fijación ...
Vertebral Destruction Syndrome (VDS) is a pathology of multiple etiologies causing structural alt... more Vertebral Destruction Syndrome (VDS) is a pathology of multiple etiologies causing structural alterations of the spine, producing deformity with neurological and mechanical alterations. In order to study VDS, a diagnostic process is carried out, sometimes with unexpected results. We undertook this study to validate the systematization of a series of studies to arrive at the diagnosis of VDS. We included 105 patients in the study with diagnosis of VDS from January 1998 to December 2005, taking into consideration specificity, sensitivity and predictive value of each integrated study in order to determine its diagnostic value. The most frequent etiology was Pott's Disease (24 cases) followed by osteomyelitis (20 cases), metastasis (18 cases) and multiple myeloma and plasmacytoma (16 cases each). The higher sensitivity in Pott's Disease was obtained with bone scan and polymerase chain reaction (PCR); for multiple myeloma, computerized axial tomography (CAT) and bone scan; CAT an...
Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grade of malignancy orig... more Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grade of malignancy originating in the nerve sheath components, fibroblasts, perineural cells, and Schwann cells. It is associated with neurofibromatosis type 1 (NF-1) with a risk of 10-13%. We present two cases of NF-1-associated MPNST. The first patient presented moderate pain with no apparent cause, in addition to the presence of intraspinal lesion demonstrated by nuclear magnetic resonance imaging (NMRI), which was managed surgically on two occasions. Histologically, it corresponded to a neurofibromatosis lesion in transition with malignant neoplasm. The second case manifested with thoracic kyphoscoliosis, pain, and an increase in volume. Associated with the deformity, MRI showed a withering tumor in the posterior thoracic region (T1-T8), observing an infiltrating, cellular sarcomatous neoplasm with immunopositivity for S-100 protein and vimentin. MPNSTs are sarcomas with a high index of recurrence with the...
Summary Background: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grad... more Summary Background: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grade of malignancy originating in the nerve sheath components, fibroblasts, perineural cells, and Schwann cells. It is associated with neurofibromatosis type 1 (NF-1) with a risk of 10–13%. Clinical cases: We present two cases of NF-1-associated MPNST. The first patient presented moderate pain with no apparent cause, in addition to the presence of intraspinal lesion demonstrated by nuclear magnetic resonance imaging (NMRI), which was managed surgically on two occasions. Histologically, it corresponded to a neurofibromatosis lesion in transition with malignant neoplasm. The second case manifested with thoracic kyphoscoliosis, pain, and an increase in volume. Associated with the deformity, MRI showed a withering tumor in the posterior thoracic region (T1–T8), observing an infiltrating, cellular sarcomatose neoplasm with immunopositivity for S-100 protein and vimentin. Conclusions: MPNSTs are ...
A novel chapter in current medical settings is the promotion and attention of esthetic aspects ra... more A novel chapter in current medical settings is the promotion and attention of esthetic aspects rather than health issues by health professionals. The human aspiration related to the search for personal beauty has generated new scenarios in medical practice. The Committee on Ethics and Transparency in the Physician-Industry Relationship (CETREMI) of the National Academy of Medicine of Mexico has analyzed this phenomenon and has issued recommendations directed both to medical professionals and to producers and potential consumers of esthetic procedures.
Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, e... more Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, es una artrodesis muy usada que produce la consecuente limitación en la movilidad, menor soporte y poca tolerancia para el esfuerzo. Con el uso de sistemas de fijación ...
Despite of the advances in the knowledge and quality of the antimicrobial, the infections in orth... more Despite of the advances in the knowledge and quality of the antimicrobial, the infections in orthopaedic surgery are being a frequent problem. The perioperatory administration of antibiotics help to its prevention, however, the use must be doing in base to strict standards, since they don't have to be used indiscriminated form, because this can favoured the bacterial resistance, as well as the toxicity. The objective of the present work is to form a criterion of the antibiotic use like prophylactic. The antibiotic prophylaxis looking for preventing and to reduce the incidence of infections in orthopaedic in a situation of calculated risk. In order to prevent infections not only the antibiotics must be used, but besides to apply some ad-juvant measurements with tendency to decrease the risk factors, like obesity, additioned diseases like mellitus diabetes , VIH, etc. General preoperatory measurements so the reduction of the postoperatory hospital stay. The prophylaxis must be man...
It is defined as the reduction of the diameter in the spinal conduct, lateral ducts and/or of the... more It is defined as the reduction of the diameter in the spinal conduct, lateral ducts and/or of the intervertebral foramina. It can happens as a generalized process of sickness or it can be located or segmented. There are motor alterations and/or sensitives of pelvic members. Qualifying for inside of pathogenesis in primary and secondary. Degenerative type is most frequent. Metabolic changes of the Intervertebral disk cause a discal dehydratation, beginning a degenerative process meaning instability. The neurogenic withdrawal being the cardinal symptom of the sickness. It is presented in adults after 50 years old in 6%. The men frequency vary from 29 to 85%. The stenosis is most frequent in low back levels. It is manifested clinically for low back pain from several evolution years so as intermittent withdrawal that it can be confused with a vascular kind problem. Besides diskal hernia and spondylolisthesis, neoplasias and pelvic or abdominal alterations include the differential diagno...
The technique of placement of pedicle screws has gradually improved, but even misplacement observ... more The technique of placement of pedicle screws has gradually improved, but even misplacement observed in 1.2 to 20% of cases, have appeared techniques fluoroscopic, tomographic and electromagnetic navigation, which led it to 1.3 to 4.3%, but nevertheless they are expensive and complex technologies. Present technique pedicle screw placement by using templates with a modification in the art, performing tomography and reconstruction in the same surgical position and with the templates of 3 or more levels. Five cases of idiopathic scoliosis were performed, with correction and instrumentation with pedicular screws, where a three-dimensional model of the spine was performed with a tomography in a surgical position, whose images were exported to a 3D printer to reconstruct the desired trajectory of the screws in a template using cylinders resting on the inverse surface of the vertebrae. The direction of the screw was planned in the center of the pedicle and parallel to the upper platform of ...
Spine tumors are uncommon injuries affecting a low percentage of the population; however, these t... more Spine tumors are uncommon injuries affecting a low percentage of the population; however, these tumors can cause significant morbidity and may be related to mortality. They represent 15% of craniospinal tumors. The objective of this study is to determine the frequency of intradural extramedullary spine tumors treated in our Service and to report the definitive histopathological diagnosis. This was a retrospective study in a series of patients treated surgically with a diagnosis of intradural extramedullary tumor in the Spine Service of the National Rehabilitation Institute (Mexico) from 1996 to 2006. The following variables were evaluated: gender, age, tumor localization, symptomatology and type of tumor. Files of 27 patients were reviewed. There were 11 men and 16 women with an average age of 47.33 years. The main symptoms were pain and motor weakness. The most frequent localization was thoracic followed by lumbar. Histopathological diagnosis reported 12 cases of meningioma, 12 cas...
OBJETIVO: Explorar la efectividad de un conjunto de pruebas de diagnósticos, sistematizadas en ho... more OBJETIVO: Explorar la efectividad de un conjunto de pruebas de diagnósticos, sistematizadas en hoja de protocolo, para la determinación del Síndrome de Destrucción Vertebral en pacientes de nuestro servicio. MÉTODOS: Analizamos una propuesta de sistematización mediante un estudio piloto de 20 pacientes a quienes se realizaron 10 diferentes pruebas de laboratorio y gabinete, además del estudio histopatológico de biopsia percutánea. Se describieron las características demográficas y clínicas, con los resultados obtenidos mediante estadística descriptiva, media y desviación estándar para las variables cuantitativas y porcentajes para las cualitativas. RESULTADOS: Edad promedio de 53,3 años ± 16,56 años; 10 hombres y 10 mujeres. 30 vértebras afectadas en los 20 pacientes, 8 de ellos tuvieron afección de dos o más vértebras. El nivel más afectado fue el Lumbar en 18 casos, seguido por el Torácico en 12. El Mal de Pott se diagnosticó en 7 casos (35%), Osteomielitis en 4 (20%), Mieloma Múl...
Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, e... more Resumo: El tratamiento de la espondilósis lumbar, con espondilolistesis menor de 25 por ciento, es una artrodesis muy usada que produce la consecuente limitación en la movilidad, menor soporte y poca tolerancia para el esfuerzo. Con el uso de sistemas de fijación ...
Vertebral Destruction Syndrome (VDS) is a pathology of multiple etiologies causing structural alt... more Vertebral Destruction Syndrome (VDS) is a pathology of multiple etiologies causing structural alterations of the spine, producing deformity with neurological and mechanical alterations. In order to study VDS, a diagnostic process is carried out, sometimes with unexpected results. We undertook this study to validate the systematization of a series of studies to arrive at the diagnosis of VDS. We included 105 patients in the study with diagnosis of VDS from January 1998 to December 2005, taking into consideration specificity, sensitivity and predictive value of each integrated study in order to determine its diagnostic value. The most frequent etiology was Pott's Disease (24 cases) followed by osteomyelitis (20 cases), metastasis (18 cases) and multiple myeloma and plasmacytoma (16 cases each). The higher sensitivity in Pott's Disease was obtained with bone scan and polymerase chain reaction (PCR); for multiple myeloma, computerized axial tomography (CAT) and bone scan; CAT an...
Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grade of malignancy orig... more Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grade of malignancy originating in the nerve sheath components, fibroblasts, perineural cells, and Schwann cells. It is associated with neurofibromatosis type 1 (NF-1) with a risk of 10-13%. We present two cases of NF-1-associated MPNST. The first patient presented moderate pain with no apparent cause, in addition to the presence of intraspinal lesion demonstrated by nuclear magnetic resonance imaging (NMRI), which was managed surgically on two occasions. Histologically, it corresponded to a neurofibromatosis lesion in transition with malignant neoplasm. The second case manifested with thoracic kyphoscoliosis, pain, and an increase in volume. Associated with the deformity, MRI showed a withering tumor in the posterior thoracic region (T1-T8), observing an infiltrating, cellular sarcomatous neoplasm with immunopositivity for S-100 protein and vimentin. MPNSTs are sarcomas with a high index of recurrence with the...
Summary Background: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grad... more Summary Background: Malignant peripheral nerve sheath tumor (MPNST) is a sarcoma with a high grade of malignancy originating in the nerve sheath components, fibroblasts, perineural cells, and Schwann cells. It is associated with neurofibromatosis type 1 (NF-1) with a risk of 10–13%. Clinical cases: We present two cases of NF-1-associated MPNST. The first patient presented moderate pain with no apparent cause, in addition to the presence of intraspinal lesion demonstrated by nuclear magnetic resonance imaging (NMRI), which was managed surgically on two occasions. Histologically, it corresponded to a neurofibromatosis lesion in transition with malignant neoplasm. The second case manifested with thoracic kyphoscoliosis, pain, and an increase in volume. Associated with the deformity, MRI showed a withering tumor in the posterior thoracic region (T1–T8), observing an infiltrating, cellular sarcomatose neoplasm with immunopositivity for S-100 protein and vimentin. Conclusions: MPNSTs are ...
A novel chapter in current medical settings is the promotion and attention of esthetic aspects ra... more A novel chapter in current medical settings is the promotion and attention of esthetic aspects rather than health issues by health professionals. The human aspiration related to the search for personal beauty has generated new scenarios in medical practice. The Committee on Ethics and Transparency in the Physician-Industry Relationship (CETREMI) of the National Academy of Medicine of Mexico has analyzed this phenomenon and has issued recommendations directed both to medical professionals and to producers and potential consumers of esthetic procedures.
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