2006, Número 5
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Acta Ortop Mex 2006; 20 (5)
Estabilización occipitocervical posterior
Cuéllar PJA
Idioma: Español
Referencias bibliográficas: 84
Paginas: 190-195
Archivo PDF: 264.46 Kb.
RESUMEN
El uso del injerto autólogo simple fue el inicio en la construcción de una masa de fusión occipitocervical, pero ante los altos índices de seudoartrosis se decidió vincular el uso del injerto a una sujeción con alambres para sostenerse en cráneo y a nivel cervical. Esta técnica no fue suficiente, se observaron telescopamientos de columna cervical en el foramen mágnum. Con Harrington y Luque, se inició la utilización de barras lisas para aumentar la seguridad y eficacia. En la década de los 70’s y 80’s comenzaba la experiencia en el uso de placas y tornillos para estabilizar a la columna lumbar. Extrapolando estos principios se iniciaba también el uso de placas y tornillos occipitocervicales. Originalmente los tornillos en cráneo se popularizaron posicionándolos bilateral y bicorticalmente, sin embargo algunos reportes indicaron una tasa elevada de aflojamiento. Se propuso y experimentó el uso de tornillos mediales sujetos a la cresta occipital interna. Las patologías degenerativas, traumáticas, tumorales y congénitas que causan inestabilidad y son tributarias de estabilizaciones posteriores representan un espectro muy amplio y multidisciplinario de este segmento tan singular de la columna vertebral. Desde el punto de vista neuroquirúrgico los abordajes descompresivos de la base de cráneo posterior se encuentran en un continuo proceso evolutivo, cosa que no sucede necesariamente con los conceptos ortopédicos que tienen como objetivo controlar la estabilidad y función de la “Unión Occipitocervical”.
REFERENCIAS (EN ESTE ARTÍCULO)
Foerster O: Die leitungsbahnen des schmerzgefuhls. Und die chirurgische Behandlung der Shmerzzustande. Beitr Z Klin Chir 1927; 138 (suppl): 266.
Hamblen DL: Occipito-Cervical fusion. Journal Bone Joint and Surgery 1967; 49 B (1):33-45.
Sanan A, Rengachary SS: The history of spinal biomechanics. Neurosurgery 1996; 39(4): 657-68.
Apostolides PJ, Dickman CA, Golfinos JG, et al: Threaded Steinmann pin fusion of the craneiovertebral junction. Spine 1996; 21(14): 1630-37.
Menezes AH, Vangilder JC, Graf CJ, et al: Craneocervical abnormalities. J. Neurosurgery 1980; 53: 444-55.
Chen HJ, Cheng MH, Lau YC: One stage posterior decompression and fusion using a Luque rod for occipito-cervical instability and neural compression. Spinal Cord 2001; 39: 101-8.
Smucker JD, Sasso RC: The evolution of spinal instrumentation for the management of occipital cervical and cervicothoracic junctional injuries. Spine 2006; 31(11): S4-S52.
Smith MD, Anderson P, Grady MS: Occipitocervical arthrodesis using contoured plate fixation. Spine 1993; 18(14): 1984-90.
Sasso RC, Jeanneret B, Fischer K, Magerl F: Occipitocervical fusion with posterior plate and screw instrumentation. Spine 1994; 19(20): 2364-68.
Vale FL, Oliver M, Cahill DW: Rigid occipitocervical fusion. J Neurosurgery (Spine 2) 1999; 91: 144-50.
Abumi K, Takada T, Shono Y, et al: Posterior occipitocervical reconstruction using cervical pedicle screws and plate-rod system. Spine 1999; 24(14): 1425-34.
Grob D, Dvorak J, Froehlich M, et al: Posterior occipitocervical fusion. A preliminary report of a new technique. Spine 1990; 16(3): 17-24.
Grob D, Schutz U, Plotz G: Occipitocervical fusion in patients with rheumatoid arthritis. Clinical Orthopaedic and related research 1999; 1(366): 46-53.
Ebraheim NA, Lu J, Biyani A, et al: An anatomic study of the thickness of the occipital bone. Spine 1996; 21(15): 1725-30.
Roberts DA, Doherty BJ, Heggeness MH: Quantitative anatomy of the occiput and the biomechanics of occipital screw fixation. Spine 1998; 23(10): 1100-08.
Ryken TC, Goel VK, Clausen JD, et al: Assesment of unicortical and bicortical fixation in a quasistatic cadaveric model. Role of bone mineral density and screw torque. Spine 1995; 20(17): 1861-67.
Currier BL, Papagelopoulos PJ, Neale PG, et al: Biomechanical evaluation of new posterior occipitocervical instrumentation system. Clinical Orthopaedics and Related Research 2003; 411: 103-15.
Anderson PA, Oza AL, Puschak TJ, et al: Biomechanics of occipitocervical fixation. Spine 2006; 31(7): 755-61.
Haher TR, Yeung AW, Caruso SA, et al: Occipital screw pullout strength. A biomechanical investigation of occipital morphology. Spine 1999; 24(1): 5-9.
Hurlbert RJ, Crawford NR, Choi WG, et al: A biomechanical evaluation of occipitocervical instrumentation: screw compared with wire fixation. J Neurosurgery (Spine 1) 1999; 90: 84-90.
Oda I, Abumi KA, Sell LC, et al: Biomechanical evaluation of five different occipito-atlanto-axial fixation techniques. Spine 1999; 24(22): 1-14.
Santillán PA, Anaya VS, Aguirre NJ, et al: Inestabilidad de la columna cervical superior. Tratamiento quirúrgico mediante dos placas anguladas de 105 grados y artrodesis posterior. Revista Mexicana de Ortopedia 1992; 6(5): 195-7.
Cuellar-Puente JA, Ramos Peek MA: Hematoma subdural postinstrumentacion occipitocervical. Archivos de Neurociencias 2000; 5(2): 103-6.
O’Brien MF, Casey AT, Crockard A, et al: Histology of the craneocervical junction in chronic rheumatoid arthritis: A clinicopathologic analysis of 33 cases. Spine 2002; 27(20): 2245-54.
Matsunaga SH, Ijiri K, Koga H: Results of a longer than 10-year follow-up of patients with rheumatoid arthritis treated by occipitocervical fusion. Spine 2000; 25(14): 1749-56.
Agrawal D, Gowda NK, Chandrahekhar SB, et al: Have cranio-vertebral junction anomalies been overlooked as a cause of vertebro-basilar insufficiency? Spine 2006; 31(7): 846-50.
Nobuhiko S, Matsunaga S, Mori T, et al: Clinical course of conservatively managed rheumatoid arthritis patients with myelopathy. Spine 1997; 22(22): 2603-07.
Sandhu FA, Pait G, Benzel E, et al: Occipitocervical fusion for rheumatoid arthritis using the inside-outside stabilization technique. Spine 2003; 28(4): 414-19.
Puttlitz CM, Goel VK, Clark CR, et al: Biomechanical rationale for the pathology of rheumatoid arthritis in the craniovertebral junction. Spine 2000; 25(13): 1607-16.
Paquis P, Breuil V, Lonjon M, et al: Occipitocervical fixation using hooks and screws for upper cervical instability. Neurosurgery 1999; 44(2): 324-30.
Deutsch H, Haid RW, Rodts GE, et al: Occipitocervical fixation: Long term results. Spine 2005; 30(5): 530-35.
Bruneau M, Cornelius JF, George B: Osteoide osteomas and osteoblastomas of the occipitocervical junction. Spine 2005; 30(19): 567-71.
Huckell CB, Buchowish JM, Richardson WJ, et al: Functional outcome of plate fusion for disorders of the occipitocervical junction. Clinical Orthopaedics and related research 1999;359: 136-45.
Hadley MN: Occipital condyle fractures. Neurosurgery 2002; 50(3): S114-S119.
Vender JR, McDonnell DE: Management of lesions involving the craneocervical junction. Neurosurgery Quarterly 2001; 11(2): 151-71.
González OMGE, Anaya VS: Lesiones del complejo occipitoatlantoaxoideo. 1998; 12(6): 518-25.
Hadley MN: Management of combination fractures of the atlas and axis in adults. Neurosurgery 2002; 50(3): S140-S147.
Milhorat TH, Chow MW, Trinidad EM, et al: Chiari I malformation redefined: Clinical and radiographic finding for 364 symptomatic patients. Neurosurgery 1999; 44(5): 1005-17.
Zileli M, Cagli S: Combined anterior and posterior approach for managing basilar invagination associates with type I Chiari malformation. Journal of Spinal Disorders and Techniques 2002; 15(4): 284-89.
Pait TG, Al-Mefty O, Boop FA, et al: Inside-Outside technique for posterior Occipitocervical Spine Instrumentation and Stabilization: Preliminary results. Journal of Neurosurgery 1999; 90(spine1): 1-7.
Wang Ch, Yan M, Zhou HT, et al: Open reduction of irreductible atlantoaxial dislocation by transoral anterior atlantoaxial release and posterior internal fixation. Spine 2006; 31(11): 306-13.
Lanzino G, Paolini S, Spetzler R: Far-Lateral approach to the Craneocervical Junction. Operative Neurosurgery 2005; 57(4): 367-71.
Foerster O: Die leitungsbahnen des schmerzgefuhls. Und die chirurgische Behandlung der Shmerzzustande. Beitr Z Klin Chir 1927; 138 (suppl): 266.
Hamblen DL: Occipito-Cervical fusion. Journal Bone Joint and Surgery 1967; 49 B (1):33-45.
Sanan A, Rengachary SS: The history of spinal biomechanics. Neurosurgery 1996; 39(4): 657-68.
Apostolides PJ, Dickman CA, Golfinos JG, et al: Threaded Steinmann pin fusion of the craneiovertebral junction. Spine 1996; 21(14): 1630-37.
Menezes AH, Vangilder JC, Graf CJ, et al: Craneocervical abnormalities. J. Neurosurgery 1980; 53: 444-55.
Chen HJ, Cheng MH, Lau YC: One stage posterior decompression and fusion using a Luque rod for occipito-cervical instability and neural compression. Spinal Cord 2001; 39: 101-8.
Smucker JD, Sasso RC: The evolution of spinal instrumentation for the management of occipital cervical and cervicothoracic junctional injuries. Spine 2006; 31(11): S4-S52.
Smith MD, Anderson P, Grady MS: Occipitocervical arthrodesis using contoured plate fixation. Spine 1993; 18(14): 1984-90.
Sasso RC, Jeanneret B, Fischer K, Magerl F: Occipitocervical fusion with posterior plate and screw instrumentation. Spine 1994; 19(20): 2364-68.
Vale FL, Oliver M, Cahill DW: Rigid occipitocervical fusion. J Neurosurgery (Spine 2) 1999; 91: 144-50.
Abumi K, Takada T, Shono Y, et al: Posterior occipitocervical reconstruction using cervical pedicle screws and plate-rod system. Spine 1999; 24(14): 1425-34.
Grob D, Dvorak J, Froehlich M, et al: Posterior occipitocervical fusion. A preliminary report of a new technique. Spine 1990; 16(3): 17-24.
Grob D, Schutz U, Plotz G: Occipitocervical fusion in patients with rheumatoid arthritis. Clinical Orthopaedic and related research 1999; 1(366): 46-53.
Ebraheim NA, Lu J, Biyani A, et al: An anatomic study of the thickness of the occipital bone. Spine 1996; 21(15): 1725-30.
Roberts DA, Doherty BJ, Heggeness MH: Quantitative anatomy of the occiput and the biomechanics of occipital screw fixation. Spine 1998; 23(10): 1100-08.
Ryken TC, Goel VK, Clausen JD, et al: Assesment of unicortical and bicortical fixation in a quasistatic cadaveric model. Role of bone mineral density and screw torque. Spine 1995; 20(17): 1861-67.
Currier BL, Papagelopoulos PJ, Neale PG, et al: Biomechanical evaluation of new posterior occipitocervical instrumentation system. Clinical Orthopaedics and Related Research 2003; 411: 103-15.
Anderson PA, Oza AL, Puschak TJ, et al: Biomechanics of occipitocervical fixation. Spine 2006; 31(7): 755-61.
Haher TR, Yeung AW, Caruso SA, et al: Occipital screw pullout strength. A biomechanical investigation of occipital morphology. Spine 1999; 24(1): 5-9.
Hurlbert RJ, Crawford NR, Choi WG, et al: A biomechanical evaluation of occipitocervical instrumentation: screw compared with wire fixation. J Neurosurgery (Spine 1) 1999; 90: 84-90.
Oda I, Abumi KA, Sell LC, et al: Biomechanical evaluation of five different occipito-atlanto-axial fixation techniques. Spine 1999; 24(22): 1-14.
Santillán PA, Anaya VS, Aguirre NJ, et al: Inestabilidad de la columna cervical superior. Tratamiento quirúrgico mediante dos placas anguladas de 105 grados y artrodesis posterior. Revista Mexicana de Ortopedia 1992; 6(5): 195-7.
Cuellar-Puente JA, Ramos Peek MA: Hematoma subdural postinstrumentacion occipitocervical. Archivos de Neurociencias 2000; 5(2): 103-6.
O’Brien MF, Casey AT, Crockard A, et al: Histology of the craneocervical junction in chronic rheumatoid arthritis: A clinicopathologic analysis of 33 cases. Spine 2002; 27(20): 2245-54.
Matsunaga SH, Ijiri K, Koga H: Results of a longer than 10-year follow-up of patients with rheumatoid arthritis treated by occipitocervical fusion. Spine 2000; 25(14): 1749-56.
Agrawal D, Gowda NK, Chandrahekhar SB, et al: Have cranio-vertebral junction anomalies been overlooked as a cause of vertebro-basilar insufficiency? Spine 2006; 31(7): 846-50.
Nobuhiko S, Matsunaga S, Mori T, et al: Clinical course of conservatively managed rheumatoid arthritis patients with myelopathy. Spine 1997; 22(22): 2603-07.
Sandhu FA, Pait G, Benzel E, et al: Occipitocervical fusion for rheumatoid arthritis using the inside-outside stabilization technique. Spine 2003; 28(4): 414-19.
Puttlitz CM, Goel VK, Clark CR, et al: Biomechanical rationale for the pathology of rheumatoid arthritis in the craniovertebral junction. Spine 2000; 25(13): 1607-16.
Paquis P, Breuil V, Lonjon M, et al: Occipitocervical fixation using hooks and screws for upper cervical instability. Neurosurgery 1999; 44(2): 324-30.
Deutsch H, Haid RW, Rodts GE, et al: Occipitocervical fixation: Long term results. Spine 2005; 30(5): 530-35.
Bruneau M, Cornelius JF, George B: Osteoide osteomas and osteoblastomas of the occipitocervical junction. Spine 2005; 30(19): 567-71.
Huckell CB, Buchowish JM, Richardson WJ, et al: Functional outcome of plate fusion for disorders of the occipitocervical junction. Clinical Orthopaedics and related research 1999;359: 136-45.
Hadley MN: Occipital condyle fractures. Neurosurgery 2002; 50(3): S114-S119.
Vender JR, McDonnell DE: Management of lesions involving the craneocervical junction. Neurosurgery Quarterly 2001; 11(2): 151-71.
González OMGE, Anaya VS: Lesiones del complejo occipitoatlantoaxoideo. 1998; 12(6): 518-25.
Hadley MN: Management of combination fractures of the atlas and axis in adults. Neurosurgery 2002; 50(3): S140-S147.
Milhorat TH, Chow MW, Trinidad EM, et al: Chiari I malformation redefined: Clinical and radiographic finding for 364 symptomatic patients. Neurosurgery 1999; 44(5): 1005-17.
Zileli M, Cagli S: Combined anterior and posterior approach for managing basilar invagination associates with type I Chiari malformation. Journal of Spinal Disorders and Techniques 2002; 15(4): 284-89.
Pait TG, Al-Mefty O, Boop FA, et al: Inside-Outside technique for posterior Occipitocervical Spine Instrumentation and Stabilization: Preliminary results. Journal of Neurosurgery 1999; 90(spine1): 1-7.
Wang Ch, Yan M, Zhou HT, et al: Open reduction of irreductible atlantoaxial dislocation by transoral anterior atlantoaxial release and posterior internal fixation. Spine 2006; 31(11): 306-13.
Lanzino G, Paolini S, Spetzler R: Far-Lateral approach to the Craneocervical Junction. Operative Neurosurgery 2005; 57(4): 367-71.
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