[Tratamiento quirúrgico de la escoliosis idiopática del adolescente. Resultados en el Instituto Nacional de Rehabilitación de México. Seguimiento mínimo de 24 meses].

Antecedentes: La escoliosis idiopática del adolescente se define como una deformidad tridimensional de la columna vertebral que se presenta entre los 10 y los 18 años, y que se manifiesta con una curvatura vertebral en el plano coronal mayor de 10°. Esta deformidad afecta al 2-3% de la población general, pero solo el 10% del total requerirá en algún momento tratamiento quirúrgico. El método de elección para el manejo es el uso de tornillos transpediculares y barras desrotadoras.

[Results to 4-year follow-up of the treatment of the cervical stenosis by corpectomy, titanium mesh cage and anterior plate fixation].

Background: Cervical spondylotic myelopathy is caused by cervical stenosis. Several techniques have been described for the treatment of multilevel disease, such as the anterior corpectomy with titanium mesh cage and anterior cervical plate placement, which has the advantage of performing a wider decompression and using the same bone as graft. However, it has caused controversy since the collapse of the mesh cage continues being a major limitation of this procedure.

[Clinical presentation of a dorsal epidural arachnoid cyst after an epidural anesthesia].

Background: Arachnoid cysts are dural diverticula with liquid content similar to cerebrospinal fluid, with 1% occurring in the spinal cord. They locate mainly in the dorsal region of the thoracic spine, and are unusual causes of spinal cord compression.

Clinical Case: The case is presented of a previously healthy 15-year-old boy, with a 20-month history of spastic paraparesis that started apparently after epidural block for ankle osteosynthesis.

[Spinal osteochondroma: diagnostic imaging and treatment. Case reports].

Background: Osteochondromas are benign bony tumours, with only 1 to 4% being located in the spine. It occurs more frequently in the cervical spine, with C2 being the vertebra most affected. The neurological presentation is slow due to the growth characteristics of the tumour.

[Profile of the patient with failed back surgery syndrome in the National Institute of Rehabilitation. Comparative analysis].

Background: Failed back surgery syndrome is a complication of spine surgery that leads to chronic pain and disability, often with disastrous emotional consequences to the patient.

Aim: To compare the profile of patients whose first surgery was performed in our hospital versus a group that underwent first spine surgery in a different centre.

Methods: Retrospective study with 65 patients; 18 formed group I (first spine surgery performed in our institution), and 47 patients in group II (first surgery performed in another hospital).

[Use of the PEEK cage in cervical spondylosis treatment].

Background: Decompression and fusion with autograft is the gold standard technique in the treatment of cervical canal strait. Using PEEK cages or boxes of non-absorbable polymer with elasticity similar to bone, radiolucent, reduces morbidity and same degree of fusion.

Methods: A case series, prospective, longitudinal, deliberate intervention, evaluation panel before and after 2 years follow-up.

[Vertebral hemangioma of the posterior arch with subsequent extraosseous extension and neurological symptoms. Case report and literature review].

Background: Vertebral hemangioma is the most common benign spinal tumor and is found in 11% of postmortem studies as a slow-growing benign vascular malformation. It usually involves the vertebral body and sometimes the posterior vertebral elements. When the posterior elements are involved, spinal cord compression with neurological symptoms are seen more often.

[Results of the surgical treatment of atlantoaxial instability].

Background: Instability of the cervical spine is defined as an increase in flexibility farther than the physiological limits of one vertebra over another in some of its axes, conditioning symptoms for the patient. Traumatic, degenerative, metabolic and neoplastic causes have all been identified.

Methods: A retrospective, longitudinal, observational and descriptive study was carried out on patients surgically intervened specifically for atlantoaxial instability from January 1993 to May 2002, with a minimum 5-year follow-up.

[Whiplash syndrome. Proposal of treatment].

The cervical sprain, also known as Whiplash Syndrome, is a frequent pathology that produces high economic losses by year in the big cities. The most common mechanism most for whiplash, is the automobile accident with collision in the backside of the car, although it can be caused by other mechanisms. The pathophysiology of the whiplash syndrome is poorly understood, therefore the treatment is controversial and poorly described in the literature.

[Surgical treatment of craniocervical instability. Review paper].

The concept of spinal instability is still controversial. Anatomical, biomechanical, clinical and radiographic variants are involved and make the definition complicated. There are solid diagnostic bases in cases of fractures and degenerative disorders; however, pure spinal instability is still under study.

[Surgical treatment for scoliosis. Minimal evolution control at 5 years].

Background: We undertook this study to determine the surgical treatments results performed often to correct scoliosis in the Spinal Surgery Service in the INR/Orthopedics (National Institute of Rehabilitation/Orthopedics), Mexico City.

Methods: We conducted a longitudinal, prospective, descriptive, and clinical study with a deliberated intervention controlled from a historical cohort. One hundred twenty patients with scoliosis were reviewed in whom surgery was performed during 1990-1999.

[Experience with prosthetic disc nucleus device in Mexico. Final report of a 4-year follow-up].

Background: Discal hernia is generally treated by discectomies that are mutilating and cause instability and low back pain in 50% of the patients. Partial arthroplasty is used in an attempt to avoid degeneration after a discectomy.

Methods: Nineteen patients from the INR (National Institute of Rehabilitation) were selected with extruded discal hernia.

[Stability effect of the suprajacent vertebrae after fixation in spondylolisthesis. Comparative study of two systems].

Background: This study was undertaken to evaluate vertebral stability after two different types of fusion fixation (rigid and semirigid) in spondylolisthesis.

Material And Methods: Ambispective study of a dynamic cohort constituted by 42 patients that underwent surgery between 1990 and 2000 for a spondilolistesis treatment. According to the fixing type, they were divided into two follow-up groups: to group 1, plate INO (semirigid system) was placed + posterolateral fusion (PLF), 20 cases; to group 2, plate INO was installed + intersomatic screw + PLF, 22 cases.