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Academia Mexicana de Neurología, A.C.

2017, Número 5

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Rev Mex Neuroci 2017; 18 (5)


¿Dónde estamos y a dónde vamos? Nuevas estrategias integrales en el manejo de hernia de disco

Ovando-Sanders E, Urias-Valdez DP, Rendón-Félix J, Echevarría-Requeijo H, Rodríguez-Cisneros DG

Idioma: Español
Referencias bibliográficas: 41
Paginas: 54-63
Archivo PDF: 174.94 Kb.


RESUMEN

En algún momento de su vida, 66% de los adultos padecerán dolor de espalda baja, de los cuales 85% tendrán al menos una hernia discal. Esta enfermedad es la causa principal de incapacidad, disminución de horas laborales y elevados costos debido a la persistencia del dolor. Históricamente, el pilar de su tratamiento ha sido a base de medicamentos, dejando los estudios de imagen y tratamientos invasivos como última opción cuando no hubo mejoría con el tratamiento conservador.
La principal justificación de la cirugía es un alivio acelerado del dolor en relación al tratamiento conservador (razón de su alta práctica) pero, además de no contar con un estándar quirúrgico, no hay diferencias en beneficios a largo plazo o disminución de costos. De la misma manera, aunque existe un consenso donde se establece que tipo de medicamento, dosis exactas o sesiones precisas de rehabilitación para la adecuada recuperación del padecimiento, cada caso debe ser individualizado.
Las nuevas estrategias de manejo integral, combinando terapias a base de antiinflamatorios, ozono y adecuada rehabilitación, han tenido resultados prometedores (remisión del dolor hasta en el 95% de los pacientes) en fases iniciales, pero falta mayor difusión para poder establecerlas como alternativas terapéuticas.


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