Discopatía cervical : evolución clínica y valoración de resultados del tratamiento con nucleoplastia a corto plazo, Hospital Alcívar 2004 - 2010
Fecha
2011
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La hernia discal cervical con compresión de la médula espinal tiene una prevalencia del 40%, los pacientes que consultan por cervicobracalgia o radiculopatías compresivas está en aumento, las opciones terapéuticas son múltiples siendo siempre su propósito un tratamiento conservador o mínimamente invasivo. Desde el año 2004 se viene realizando en el Hospital Alcívar de la ciudad de Guayaquil, la nucleoplastia cervical percutánea obteniendo excelentes resultados; con el objetivo de evaluar esta experiencia, se propone realizar este trabajo de investigación mediante un estudio descriptivo correlacional, diseño no experimental, longitudinal y retrospectivo; la muestra está conformada por los pacientes intervenidos desde Enero del 2004 hasta septiembre del 2010. Realizando valoración prequirúrgica, con evaluación subjetiva y objetiva de los resultados clínicos en los 15 días subsiguientes a la intervención, 30, 90 y 180 días posteriores al procedimiento, teniendo como instrumentos escalas cualitativas y cuantitativas obtenidas a partir de la entrevista, historia clínica, exámenes complementarios y record quirúrgico de los pacientes. De su evaluación los resultados evidenciaron disminución del dolor de 9 puntos según la escala numérica, los pacientes presentaron recuperación funcional con la valoración de oswestry del 65%, la evaluación subjetiva de los individuos muestra satisfacción absoluta en el 87.04% de los casos. En conclusión esta técnica de nucleoplastia es ambulatoria, se realiza bajo anestesia local, es segura y útil en el tratamiento de hernias cervicales contenidas, con evolución clínica excelente y sin complicaciones.
The prevalence of Discal cervical hernia with medular spine compression is about 40%, the patients who consults for cervicobracalgia or compressive radiculopathy by cervical disc herniation is increasing, options treatment are being provided their purpose multiple conservative treatment or minimally invasive. Since 2004 in Hospital Alcívar has been performing cervical Percutaneous Disc Decompression with excellent results, with the aim of raising awareness of this experience, it proposes to carry out this research, a descriptive correlational nonexperimental, longitudinal and retrospective, the sample will consist for all patients undergoing percutaneous cervical Nucleoplasty from January 2004 until September 2010. Performing a preoperative assesment, with subjective and objective assesment of clinical outcomes within 15 days after surgery, 30, 90 and 180 days after the procedure, used as instruments qualitative and quantitative scales obtained from the interview, medical history, record additional examinations and surgical patients. The results obtained showed reduced pain nine points according numeric pain scale, patients functional recovery with the valuation of Oswestry 65%, subjective assessment of sample individuals absolute satisfaction in 87.04% of cases. In conclusion this technique outpatient basis under local anesthesia is safe and useful in the treatment of contained cervical hernias, with excellent clinical results, no complications.
The prevalence of Discal cervical hernia with medular spine compression is about 40%, the patients who consults for cervicobracalgia or compressive radiculopathy by cervical disc herniation is increasing, options treatment are being provided their purpose multiple conservative treatment or minimally invasive. Since 2004 in Hospital Alcívar has been performing cervical Percutaneous Disc Decompression with excellent results, with the aim of raising awareness of this experience, it proposes to carry out this research, a descriptive correlational nonexperimental, longitudinal and retrospective, the sample will consist for all patients undergoing percutaneous cervical Nucleoplasty from January 2004 until September 2010. Performing a preoperative assesment, with subjective and objective assesment of clinical outcomes within 15 days after surgery, 30, 90 and 180 days after the procedure, used as instruments qualitative and quantitative scales obtained from the interview, medical history, record additional examinations and surgical patients. The results obtained showed reduced pain nine points according numeric pain scale, patients functional recovery with the valuation of Oswestry 65%, subjective assessment of sample individuals absolute satisfaction in 87.04% of cases. In conclusion this technique outpatient basis under local anesthesia is safe and useful in the treatment of contained cervical hernias, with excellent clinical results, no complications.
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Palabras clave
Columna cervical, Desplazamiento del disco, Nucleoplastia, Epidemiología descriptiva, Estudios retrospectivos, Hospital Alcívar, Cantón Guayaquil, Ecuador, Espondilosis, Evolución clínica