2015, Número 2
<< Anterior
Acta Ortop Mex 2015; 29 (2)
Escoliosis degenerativa del adulto
García-Ramos CL, Obil-Chavarría CA, Zárate-Kalfópulos B, Rosales-Olivares LM, Alpizar-Aguirre A, Reyes-Sánchez AA
Idioma: Español
Referencias bibliográficas: 50
Paginas: 127-138
Archivo PDF: 315.55 Kb.
RESUMEN
La escoliosis del adulto es una deformidad rotacional compleja tridimensional de la columna, resultado de la degeneración progresiva de los elementos vertebrales en la edad madura, en una columna previamente recta; con un ángulo de Cobb mayor de 10º en el plano coronal, que además altera los planos sagital y axial. Se origina de una enfermedad degenerativa, asimétrica del disco y las facetas articulares, creando cargas asimétricas y posteriormente deformidad. El síntoma principal es dolor axial, radicular y déficit neurológico. El tratamiento conservador incluye fármacos y terapia física. Las infiltraciones epidurales y facetarias para bloqueo selectivo de raíces nerviosas mejora el dolor a corto plazo. El tratamiento quirúrgico se reserva para pacientes con dolor intratable, radiculopatía y/o déficit neurológico. No existe un consenso para las indicaciones quirúrgicas, sin embargo, se debe tener un entendimiento claro de los síntomas y signos clínicos. La meta de la cirugía es la descompresión de elementos neurales con restauración, modificación de la deformidad en forma tridimensional y estabilización del balance coronal y sagital.
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