I read the Expert's Comment from A. Lazary regarding "Percutaneous cement discoplasty fo... more I read the Expert's Comment from A. Lazary regarding "Percutaneous cement discoplasty for the treatment of advanced degenerative disk disease in elderly patients" with interest. I would like to reply him addressing important comments about Percutaneous Cement Discoplasty (PCD). First, A. Lazary belongs to the original group who developed this minimally invasive PCD technique to treat low back pain in patients with vacuum phenomenon and vertical intervertebral instability leaded by Peter Pal Varga. Therefore, their group have made a huge contribution to this new promising technique that has encouraged us to follow their enthusiasm with a common goal, to improve the quality of life in elderly patient with chronic low back pain as an alternative to traditional fusion surgery. We agree with Lazary to the fact that only significant amount of vacuum phenomenon should be considered to perform PCD as partial vacuum implies the presence of intervertebral disk remnant tissue preventing segmental stabilization with possible complications and less clinical effect. In this regard, we developed a classification of vacuum phenomenon [1] considering two important factors: The amount of vacuum and the presence of subchondral sclerosis. We concluded that the higher amount of vacuum with subchondral sclerosis (called total vacuum or type 3B) is the best scenario to achieve segmental stabilization. On the other hand, as Lazary mentioned, there is no clear consensus about fusion in the long term, and only longer followup studies would answer that concern. Dr. Lazary argued that our technique differs from the original regarding the use of intraoperative neuromonitoring (IONM) during the procedure [2], referring that its use could increase surgical time and hospital costs, questioning its utility. We agreed with Dr. Lazary in which the use of intraoperative neuromonitoring increases costs and could not be entirely required in all cases. However, we believe that neuromonitoring can be useful specially when inserting the cannula through kambin’s triangle because there could be a risk for nerve root injury. Unfortunately, we have some cases that underwent postoperative radicular pain during PCD, after ruling out other causes such as cement leakage or fracture, we concluded that radicular irritation due to cannula misplacement was a cause of postoperative radicular pain as the symptoms correlated with the exiting nerve root and were not present before surgery. In this regard, the use of neuromonitoring allowed us to early detect radicular irritation probably due to cannula proximity during the Jamshidi insertion phase that can be relieved by changing the cannula entry point, this is particularly useful in cases in which the anatomy of kambin’s triangle is modified by tri-dimensional deformity as observed in patients with degenerative scoliosis or during cement injection in which early cement leakage into the canal would allow us to stop cement injection, in this situation, a true positive neuromonitoring finding would * Gaston Camino-Willhuber gaston.camino@hospitalitaliano.org.ar
Revista de la Facultad de Ciencias Médicas de Córdoba
Introduction: Epidural injections are frequent and safe procedures. Severe complications are infr... more Introduction: Epidural injections are frequent and safe procedures. Severe complications are infrequent, and they have been reported in elderly comorbid patients with predisposing factors. The objectives of this work are to present a case of an extensive epidural lumbar abscess in a young non-comorbid male patient after a therapeutic L5-S1 injection and a literature review about this subject. Case Presentation An otherwise healthy 24-year-old man who present a case of an extensive epidural lumbar abscess after a therapeutic nerve root block due to a disc herniation. After 7 days of fever and low back pain, he required two surgical interventions and intravenous antibiotic therapy. We reviewed 18 patients with epidural abscess consequence of spinal injections. Their mean age was 54.5 y.o, 66.5% were male, and 66.5% had at least one predisposing risk factor. Symptoms Onset occurred at 8 days on average after the procedure, but the correct diagnosis was made at the 25th-day average. O...
Revista de la Facultad de Ciencias Médicas de Córdoba, 2020
Introduction Chylous leakage into the retroperitoneum is a rare complication after spinal surgery... more Introduction Chylous leakage into the retroperitoneum is a rare complication after spinal surgery using an anterior retroperitoneal approach. Chylothorax is the presence of lymphatic fluid in the pleural cavity and it is even less frequent during these surgeries. The aim of this work is to report the first case of isolated left chylothorax after a retroperitoneal Left Oblique Lumbar Interbody Fusion in supine position in an adult female patient. Case A female 30-years-old patient underwent L4-L5 anterior interbody fusion. Four days after the intervention she was diagnosed with isolated left chylothorax that was drained and treated conservatively with good outcomes. Conclusion Chylothorax is an extremely rare complication after anterior lumbar spine procedures, and it is usually secondary to a chyloretroperitoneum. We present a unique case of isolated chylothorax after anterior retroperitoneal lumbar approach successfully treated in a conservative manner. Key Words chylothorax;...
Revista de la Asociación Argentina de Ortopedia y Traumatologia, 2021
Introduction: Minimally invasive techniques for the treatment of thoracolumbar fractures have bee... more Introduction: Minimally invasive techniques for the treatment of thoracolumbar fractures have been developed to reduce perioperative morbidity. The primary purpose of this work is to evaluate the clinical and radiological outcomes in a group of patients with traumatic thoracolumbar fracture treated with minimally invasive procedures. Materials and methods: Taking a group of patients within the inclusion criteria, we retrospectively analyzed demographic data, along with pre and postoperative radiographic measurements and postoperative functional scores, using the Oswestry Disability Index and the Visual Analog Scale for pain. We recorded the complications and the hospital stay. Results: 15 patients were analyzed (10 of them were male). The average age was 59 years, and the average follow-up was 32.9 months. The patients presented an average postoperative pain score of 2/10 and an average Oswestry Disability Index score of 14/100. The radiographic analysis showed an average preoperati...
Revista de la Facultad de Ciencias Médicas de Córdoba, 2021
Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back... more Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter. The objective of this study was to assess the usefulness of neuromonitoring during discoplasty to detect new neurological compromise. Methods: 100 consecutive patients were included in this retrospective study, (30 males and 70 females, mean age of 76.3 ± 5.71 years) with mechanical low back pain who underwent percutaneous cement discoplasty. Results: Sensitivity to detect neurological injury was 82% (CI 95% 66-98), specificity was of 99% (CI 95%98-100) with a positive predictive value of 0.95 (CI 95% 85-100) and a negative predictive value of 0.97 (CI 95% 95-99). In 5 patients neurological compromise was not detected by neuromonitoring. D...
BACKGROUND To report clinical results after percutaneous cement discoplasty (PCD) in a multicentr... more BACKGROUND To report clinical results after percutaneous cement discoplasty (PCD) in a multicentric case series with a minimum of two years follow up. METHODS Between December 2014 and January 2019, 180 patients with low back pain and advanced degeneration were treated with percutaneous discoplasty in two centers. INCLUSION CRITERIA WERE 65 year or older, mechanical low back pain with or without spinal stenosis that did not respond to conservative management. Patients were divided into three groups; Group 1: patients without previous spine surgeries who underwent PCD; Group 2: patients with previous spine surgeries who underwent PCD, and Group 3: patients with/without previous surgery who underwent PCD plus decompression surgery. Clinical and radiological analysis were performed as well as complication and readmission rates. RESULTS 156 patients, 74% female, mean age 75.8 ± 5.7, mean BMI 29.9 ± 5.2 were included in our study. Overall preoperative Visual Analogue Score (VAS) and Oswestri Disability Index (ODI) were 7.8 ± 0.9 and 68.1 ± 9.6, respectively. At 2 years follow up, mean VAS improvement was 3.56 (CI 95% 3.92 -3.20; p<0.0001) and mean ODI improvement was 17.18 (CI 95 % 19.52 to 14.85; p<0.0001) showing a significant and sustained improvement in both scores. Additionally, 84% of patients reached both VAS and ODI minimum important clinical difference at final follow-up. Finally, 5.7% of patients suffered major complications 30 days postoperatively. CONCLUSIONS Percutaneous cement discoplasty showed significant improvement of VAS and ODI scores at two years follow-up with relatively low rate of complications.
Study Design: Diagnostic study, level of evidence III. Objectives: Low back pain is a common caus... more Study Design: Diagnostic study, level of evidence III. Objectives: Low back pain is a common cause of disability among elderly patients. Percutaneous discoplasty has been developed as a tool to treat degenerative disease when conservative management is not successful. Indications for this procedure include low back pain and the presence of vacuum phenomenon. The objective of this study was to describe a new classification of vacuum phenomenon based on computed tomography scan in order to improve the indications for percutaneous discoplasty. Methods: We developed a classification of vacuum phenomenon based on computed tomography scan images. We describe 3 types of vacuum based on the relationship between vacuum and the superior/inferior endplates and 2 subtypes based on the presence of significant subchondral sclerosis. A validation study was conducted selecting 10 orthopedic residents with spine surgery training to analyze 25 vacuum scenarios. Inter- and intraobserver reliabilities ...
Revista de la Asociación Argentina de Ortopedia y Traumatología, 2019
El osteosarcoma “tipo osteoblastoma”, una variante menos agresiva del osteosarcoma, es una enferm... more El osteosarcoma “tipo osteoblastoma”, una variante menos agresiva del osteosarcoma, es una enfermedad poco frecuente y representa un desafío diagnóstico tanto clínico como histopatológico. Se han publicado escasos reportes de casos de este tumor.Presentamos a un paciente de 16 años con un osteosarcoma “tipo osteoblastoma” localizado en la columna cervical. La biopsia ósea bajo tomografía reveló una lesión con un patrón de crecimiento permeativo, con sospecha de osteosarcoma “tipo osteoblastoma”. Se realizó una espondilectomía total en bloque mediante un doble abordaje. Se describen el caso clínico, la secuencia diagnóstica, la técnica quirúrgica y el seguimiento a 10 años. ABSTRACT Osteoblastoma-like osteosarcoma; a less aggressive variant of osteosarcoma;is a rare entity and represents a clinical and histopathological diagnostic challenge. We have found few reports of cases of this tumor in the literature. In this case we describe an osteoblastoma-like osteosarcoma located in the c...
Retrospective analysis. Level of evidence III. Low-energy vertebral compression fractures are an ... more Retrospective analysis. Level of evidence III. Low-energy vertebral compression fractures are an increasing socioeconomic problem among elderly patients. Percutaneous vertebroplasty has been extensively used for the treatment of painful fractures because of its effectiveness. However, some complications have been described; among them, new vertebral compression fractures, whether adjacent or not to the treated vertebra, are commonly reported complications (8% to 52%). We retrospectively analyzed epidemiological and technical variables presumably associated with new vertebral compression fractures. To determine the relationship between new vertebral compression fracture and percutaneous vertebroplasty, 30 patients (study group) with this complication were compared with 60 patients treated with percutaneous vertebroplasty without this condition (control group). A higher cement percentage was found in the study group (40.3%) compared with the control group (30.5%). Initial vertebral ky...
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 23, 2018
The authors describe a percutaneous technique to treat advanced degenerative disk disease in elde... more The authors describe a percutaneous technique to treat advanced degenerative disk disease in elderly patients. A step-by-step technical description based on our experience in selected cases. Postoperative imaging results are presented as well as indications and recommendations. Percutaneous discoplasty can result as an alternative minimal invasive strategy for the treatment of advanced degenerative disk disease.
Revista de la Asociación Argentina de Ortopedia y Traumatología, 2013
Introducción: La fotografía digital de radiografías puede generar distorsiones angulares en la... more Introducción: La fotografía digital de radiografías puede generar distorsiones angulares en las imágenes. No está publicado si estas alteraciones pueden afectar las mediciones de los ángulos de Cobb. Objetivo: Evaluar la reproducibilidad del ángulo de Cobb con la fotografía digital de espinogramas de 30 x 90 cm en escoliosis del adulto. Materiales y Métodos: Se eligieron al azar 20 espinogramas preoperatorios de pacientes con escoliosis del adulto para evaluar prospectivamente. Los espinogramas fueron escaneados y sus imágenes digitales se consideraron como controles. Se analizó la discrepancia intraobservador, interobservador, intercámara e intracámara, con tres cámaras digitales y dos observadores que realizaron ocho sesiones fotográficas a cada espinograma. Se midieron los ángulos con Adobe Photoshop® sobre las imágenes digitales y se los analizó con el coeficiente de correlación de Pearson. Resultados: El promedio de los ángulos de Cobb torácicos y lumbares del escáner, las...
Revista de la Asociación Argentina de Ortopedia y Traumatología, 2015
RESUMENIntroducción: El tratamiento quirúrgico de las fracturas toracolumbares es controvertid... more RESUMENIntroducción: El tratamiento quirúrgico de las fracturas toracolumbares es controvertido. La vía de abordaje y la cantidad de niveles de instrumentación son motivo de debate. El objetivo de este estudio fue analizar los resultados radiológicos y clínicos de pacientes con fracturas toracolumbares por estallido y flexión/distracción.MaterialesyMétodos: Estudio retrospectivo de una serie consecutiva de pacientes tratados quirúrgicamente entre 2004 y 2008, con seguimiento >12 meses. Se incluyeron pacientes con instrumentación y artrodesis corta de los niveles adyacentes a la lesión, abordados por vía posterior. Se tomaron en cuenta fracturas de tipo A3 y B de la clasificación AO. Se llevaron a cabo evaluaciones clínica, neurológica y radiológica.Resultados: Se registraron 25 pacientes, 3 se perdieron en el seguimiento y 22 fueron analizados. El promedio de edad fue de 37 años. La causa más frecuente fue caída de altura, seguida de accidente vehicular. El nivel más afectad...
303 Abstract The minimally-invasive lateral approach of the lumbar spine for interbody fusion is ... more 303 Abstract The minimally-invasive lateral approach of the lumbar spine for interbody fusion is a relatively new technique and has got promising results in patients with different lumbar spine conditions. It is a safe technique that provides the spine with appropriate structural support between vertebral endplates, it can correct deformities on coronal and sagittal planes and conduct indirect decompression of the spinal canal with preservation of the posterior elements. Over the past few years the evidence that backs this technique has been increasing and diversifying, there are reports on new indications and midand long-term results. The aim of this work is to describe the surgical procedure step by step with its variant procedures as we conduct it at the Centers we work at, and to point out related current concepts based on a bibliographic revision.
I read the Expert's Comment from A. Lazary regarding "Percutaneous cement discoplasty fo... more I read the Expert's Comment from A. Lazary regarding "Percutaneous cement discoplasty for the treatment of advanced degenerative disk disease in elderly patients" with interest. I would like to reply him addressing important comments about Percutaneous Cement Discoplasty (PCD). First, A. Lazary belongs to the original group who developed this minimally invasive PCD technique to treat low back pain in patients with vacuum phenomenon and vertical intervertebral instability leaded by Peter Pal Varga. Therefore, their group have made a huge contribution to this new promising technique that has encouraged us to follow their enthusiasm with a common goal, to improve the quality of life in elderly patient with chronic low back pain as an alternative to traditional fusion surgery. We agree with Lazary to the fact that only significant amount of vacuum phenomenon should be considered to perform PCD as partial vacuum implies the presence of intervertebral disk remnant tissue preventing segmental stabilization with possible complications and less clinical effect. In this regard, we developed a classification of vacuum phenomenon [1] considering two important factors: The amount of vacuum and the presence of subchondral sclerosis. We concluded that the higher amount of vacuum with subchondral sclerosis (called total vacuum or type 3B) is the best scenario to achieve segmental stabilization. On the other hand, as Lazary mentioned, there is no clear consensus about fusion in the long term, and only longer followup studies would answer that concern. Dr. Lazary argued that our technique differs from the original regarding the use of intraoperative neuromonitoring (IONM) during the procedure [2], referring that its use could increase surgical time and hospital costs, questioning its utility. We agreed with Dr. Lazary in which the use of intraoperative neuromonitoring increases costs and could not be entirely required in all cases. However, we believe that neuromonitoring can be useful specially when inserting the cannula through kambin’s triangle because there could be a risk for nerve root injury. Unfortunately, we have some cases that underwent postoperative radicular pain during PCD, after ruling out other causes such as cement leakage or fracture, we concluded that radicular irritation due to cannula misplacement was a cause of postoperative radicular pain as the symptoms correlated with the exiting nerve root and were not present before surgery. In this regard, the use of neuromonitoring allowed us to early detect radicular irritation probably due to cannula proximity during the Jamshidi insertion phase that can be relieved by changing the cannula entry point, this is particularly useful in cases in which the anatomy of kambin’s triangle is modified by tri-dimensional deformity as observed in patients with degenerative scoliosis or during cement injection in which early cement leakage into the canal would allow us to stop cement injection, in this situation, a true positive neuromonitoring finding would * Gaston Camino-Willhuber gaston.camino@hospitalitaliano.org.ar
Revista de la Facultad de Ciencias Médicas de Córdoba
Introduction: Epidural injections are frequent and safe procedures. Severe complications are infr... more Introduction: Epidural injections are frequent and safe procedures. Severe complications are infrequent, and they have been reported in elderly comorbid patients with predisposing factors. The objectives of this work are to present a case of an extensive epidural lumbar abscess in a young non-comorbid male patient after a therapeutic L5-S1 injection and a literature review about this subject. Case Presentation An otherwise healthy 24-year-old man who present a case of an extensive epidural lumbar abscess after a therapeutic nerve root block due to a disc herniation. After 7 days of fever and low back pain, he required two surgical interventions and intravenous antibiotic therapy. We reviewed 18 patients with epidural abscess consequence of spinal injections. Their mean age was 54.5 y.o, 66.5% were male, and 66.5% had at least one predisposing risk factor. Symptoms Onset occurred at 8 days on average after the procedure, but the correct diagnosis was made at the 25th-day average. O...
Revista de la Facultad de Ciencias Médicas de Córdoba, 2020
Introduction Chylous leakage into the retroperitoneum is a rare complication after spinal surgery... more Introduction Chylous leakage into the retroperitoneum is a rare complication after spinal surgery using an anterior retroperitoneal approach. Chylothorax is the presence of lymphatic fluid in the pleural cavity and it is even less frequent during these surgeries. The aim of this work is to report the first case of isolated left chylothorax after a retroperitoneal Left Oblique Lumbar Interbody Fusion in supine position in an adult female patient. Case A female 30-years-old patient underwent L4-L5 anterior interbody fusion. Four days after the intervention she was diagnosed with isolated left chylothorax that was drained and treated conservatively with good outcomes. Conclusion Chylothorax is an extremely rare complication after anterior lumbar spine procedures, and it is usually secondary to a chyloretroperitoneum. We present a unique case of isolated chylothorax after anterior retroperitoneal lumbar approach successfully treated in a conservative manner. Key Words chylothorax;...
Revista de la Asociación Argentina de Ortopedia y Traumatologia, 2021
Introduction: Minimally invasive techniques for the treatment of thoracolumbar fractures have bee... more Introduction: Minimally invasive techniques for the treatment of thoracolumbar fractures have been developed to reduce perioperative morbidity. The primary purpose of this work is to evaluate the clinical and radiological outcomes in a group of patients with traumatic thoracolumbar fracture treated with minimally invasive procedures. Materials and methods: Taking a group of patients within the inclusion criteria, we retrospectively analyzed demographic data, along with pre and postoperative radiographic measurements and postoperative functional scores, using the Oswestry Disability Index and the Visual Analog Scale for pain. We recorded the complications and the hospital stay. Results: 15 patients were analyzed (10 of them were male). The average age was 59 years, and the average follow-up was 32.9 months. The patients presented an average postoperative pain score of 2/10 and an average Oswestry Disability Index score of 14/100. The radiographic analysis showed an average preoperati...
Revista de la Facultad de Ciencias Médicas de Córdoba, 2021
Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back... more Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter. The objective of this study was to assess the usefulness of neuromonitoring during discoplasty to detect new neurological compromise. Methods: 100 consecutive patients were included in this retrospective study, (30 males and 70 females, mean age of 76.3 ± 5.71 years) with mechanical low back pain who underwent percutaneous cement discoplasty. Results: Sensitivity to detect neurological injury was 82% (CI 95% 66-98), specificity was of 99% (CI 95%98-100) with a positive predictive value of 0.95 (CI 95% 85-100) and a negative predictive value of 0.97 (CI 95% 95-99). In 5 patients neurological compromise was not detected by neuromonitoring. D...
BACKGROUND To report clinical results after percutaneous cement discoplasty (PCD) in a multicentr... more BACKGROUND To report clinical results after percutaneous cement discoplasty (PCD) in a multicentric case series with a minimum of two years follow up. METHODS Between December 2014 and January 2019, 180 patients with low back pain and advanced degeneration were treated with percutaneous discoplasty in two centers. INCLUSION CRITERIA WERE 65 year or older, mechanical low back pain with or without spinal stenosis that did not respond to conservative management. Patients were divided into three groups; Group 1: patients without previous spine surgeries who underwent PCD; Group 2: patients with previous spine surgeries who underwent PCD, and Group 3: patients with/without previous surgery who underwent PCD plus decompression surgery. Clinical and radiological analysis were performed as well as complication and readmission rates. RESULTS 156 patients, 74% female, mean age 75.8 ± 5.7, mean BMI 29.9 ± 5.2 were included in our study. Overall preoperative Visual Analogue Score (VAS) and Oswestri Disability Index (ODI) were 7.8 ± 0.9 and 68.1 ± 9.6, respectively. At 2 years follow up, mean VAS improvement was 3.56 (CI 95% 3.92 -3.20; p<0.0001) and mean ODI improvement was 17.18 (CI 95 % 19.52 to 14.85; p<0.0001) showing a significant and sustained improvement in both scores. Additionally, 84% of patients reached both VAS and ODI minimum important clinical difference at final follow-up. Finally, 5.7% of patients suffered major complications 30 days postoperatively. CONCLUSIONS Percutaneous cement discoplasty showed significant improvement of VAS and ODI scores at two years follow-up with relatively low rate of complications.
Study Design: Diagnostic study, level of evidence III. Objectives: Low back pain is a common caus... more Study Design: Diagnostic study, level of evidence III. Objectives: Low back pain is a common cause of disability among elderly patients. Percutaneous discoplasty has been developed as a tool to treat degenerative disease when conservative management is not successful. Indications for this procedure include low back pain and the presence of vacuum phenomenon. The objective of this study was to describe a new classification of vacuum phenomenon based on computed tomography scan in order to improve the indications for percutaneous discoplasty. Methods: We developed a classification of vacuum phenomenon based on computed tomography scan images. We describe 3 types of vacuum based on the relationship between vacuum and the superior/inferior endplates and 2 subtypes based on the presence of significant subchondral sclerosis. A validation study was conducted selecting 10 orthopedic residents with spine surgery training to analyze 25 vacuum scenarios. Inter- and intraobserver reliabilities ...
Revista de la Asociación Argentina de Ortopedia y Traumatología, 2019
El osteosarcoma “tipo osteoblastoma”, una variante menos agresiva del osteosarcoma, es una enferm... more El osteosarcoma “tipo osteoblastoma”, una variante menos agresiva del osteosarcoma, es una enfermedad poco frecuente y representa un desafío diagnóstico tanto clínico como histopatológico. Se han publicado escasos reportes de casos de este tumor.Presentamos a un paciente de 16 años con un osteosarcoma “tipo osteoblastoma” localizado en la columna cervical. La biopsia ósea bajo tomografía reveló una lesión con un patrón de crecimiento permeativo, con sospecha de osteosarcoma “tipo osteoblastoma”. Se realizó una espondilectomía total en bloque mediante un doble abordaje. Se describen el caso clínico, la secuencia diagnóstica, la técnica quirúrgica y el seguimiento a 10 años. ABSTRACT Osteoblastoma-like osteosarcoma; a less aggressive variant of osteosarcoma;is a rare entity and represents a clinical and histopathological diagnostic challenge. We have found few reports of cases of this tumor in the literature. In this case we describe an osteoblastoma-like osteosarcoma located in the c...
Retrospective analysis. Level of evidence III. Low-energy vertebral compression fractures are an ... more Retrospective analysis. Level of evidence III. Low-energy vertebral compression fractures are an increasing socioeconomic problem among elderly patients. Percutaneous vertebroplasty has been extensively used for the treatment of painful fractures because of its effectiveness. However, some complications have been described; among them, new vertebral compression fractures, whether adjacent or not to the treated vertebra, are commonly reported complications (8% to 52%). We retrospectively analyzed epidemiological and technical variables presumably associated with new vertebral compression fractures. To determine the relationship between new vertebral compression fracture and percutaneous vertebroplasty, 30 patients (study group) with this complication were compared with 60 patients treated with percutaneous vertebroplasty without this condition (control group). A higher cement percentage was found in the study group (40.3%) compared with the control group (30.5%). Initial vertebral ky...
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 23, 2018
The authors describe a percutaneous technique to treat advanced degenerative disk disease in elde... more The authors describe a percutaneous technique to treat advanced degenerative disk disease in elderly patients. A step-by-step technical description based on our experience in selected cases. Postoperative imaging results are presented as well as indications and recommendations. Percutaneous discoplasty can result as an alternative minimal invasive strategy for the treatment of advanced degenerative disk disease.
Revista de la Asociación Argentina de Ortopedia y Traumatología, 2013
Introducción: La fotografía digital de radiografías puede generar distorsiones angulares en la... more Introducción: La fotografía digital de radiografías puede generar distorsiones angulares en las imágenes. No está publicado si estas alteraciones pueden afectar las mediciones de los ángulos de Cobb. Objetivo: Evaluar la reproducibilidad del ángulo de Cobb con la fotografía digital de espinogramas de 30 x 90 cm en escoliosis del adulto. Materiales y Métodos: Se eligieron al azar 20 espinogramas preoperatorios de pacientes con escoliosis del adulto para evaluar prospectivamente. Los espinogramas fueron escaneados y sus imágenes digitales se consideraron como controles. Se analizó la discrepancia intraobservador, interobservador, intercámara e intracámara, con tres cámaras digitales y dos observadores que realizaron ocho sesiones fotográficas a cada espinograma. Se midieron los ángulos con Adobe Photoshop® sobre las imágenes digitales y se los analizó con el coeficiente de correlación de Pearson. Resultados: El promedio de los ángulos de Cobb torácicos y lumbares del escáner, las...
Revista de la Asociación Argentina de Ortopedia y Traumatología, 2015
RESUMENIntroducción: El tratamiento quirúrgico de las fracturas toracolumbares es controvertid... more RESUMENIntroducción: El tratamiento quirúrgico de las fracturas toracolumbares es controvertido. La vía de abordaje y la cantidad de niveles de instrumentación son motivo de debate. El objetivo de este estudio fue analizar los resultados radiológicos y clínicos de pacientes con fracturas toracolumbares por estallido y flexión/distracción.MaterialesyMétodos: Estudio retrospectivo de una serie consecutiva de pacientes tratados quirúrgicamente entre 2004 y 2008, con seguimiento >12 meses. Se incluyeron pacientes con instrumentación y artrodesis corta de los niveles adyacentes a la lesión, abordados por vía posterior. Se tomaron en cuenta fracturas de tipo A3 y B de la clasificación AO. Se llevaron a cabo evaluaciones clínica, neurológica y radiológica.Resultados: Se registraron 25 pacientes, 3 se perdieron en el seguimiento y 22 fueron analizados. El promedio de edad fue de 37 años. La causa más frecuente fue caída de altura, seguida de accidente vehicular. El nivel más afectad...
303 Abstract The minimally-invasive lateral approach of the lumbar spine for interbody fusion is ... more 303 Abstract The minimally-invasive lateral approach of the lumbar spine for interbody fusion is a relatively new technique and has got promising results in patients with different lumbar spine conditions. It is a safe technique that provides the spine with appropriate structural support between vertebral endplates, it can correct deformities on coronal and sagittal planes and conduct indirect decompression of the spinal canal with preservation of the posterior elements. Over the past few years the evidence that backs this technique has been increasing and diversifying, there are reports on new indications and midand long-term results. The aim of this work is to describe the surgical procedure step by step with its variant procedures as we conduct it at the Centers we work at, and to point out related current concepts based on a bibliographic revision.
Uploads
Papers by Carlos Solá