Ferreyro IR, Rojas JR, Escobar GML, García OR, Mireles EM, Salgado LP, Sánchez CJ

Idioma: Español
Referencias bibliográficas: 52
Paginas: 499-508
Archivo PDF: 582.34 Kb.

RESUMEN

De agosto de 1999 a febrero de 2002 se realizaron 55 vertebroplastías percutáneas en 35 pacientes, de los cuales 31 fueron secundarios a osteoporosis, 3 pacientes por anomalías vasculares y 1 paciente por mieloma múltiple.
La osteoporosis es el principal factor predisponente para el colapso vertebral y las probabilidades aumentan al incrementarse la expectativa de vida de la población. Al disminuir la capacidad de carga de las vértebras por pérdida de sus trabéculas, ocurre un proceso de lenta evolución con pequeñas fracturas responsables de la deformidad en cuña o pérdida de altura en el paciente senil. Cuando ocurre una fractura brusca con colapso, multifragmentada, expansiva o secundaria a necrosis avascular se asocia frecuentemente a manifestaciones clínicas importantes.
El tratamiento conservador puede ser suficiente para el manejo de fracturas de cuerpos vertebrales. Sin embargo, en aquellos pacientes con dolor severo e incapacitante, la vertebroplastía percutánea es el tratamiento de elección. La selección de los pacientes que pueden beneficiarse con este procedimiento y la identificación de los cuerpos vertebrales responsables del dolor requiere del apoyo de métodos de imagen que incluyen Gammagrafía ósea, de preferencia con SPECT, Imagen por Resonancia Magnética y Tomografía Computada. El uso apropiado de éstos permite brindar el mayor beneficio a los pacientes que lo requieren y evita riesgos y costos innecesarios a aquellos que no lo necesitan.

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