Fracturas por compresión vertical de columna lumbar
Keywords:
FC- fractura de columnaAbstract
RESUMENFundamento: las fracturas de columna por el mecanismo de compresión axial sin lesión neurológica, constituyen un paradigma en relación a su tratamiento conservador o quirúrgico. Existen controversias en la literatura sobre el tipo de tratamiento de esta lesión.
Objetivo: realizar una revisión sobre los criterios de selección de ambos tipos de tratamiento.
Métodos: se realizó una revisión bibliográfica de un total de 330 artículos publicados en Pubmed, Hinari y Medline mediante el localizador de información Endnote, de ellos se utilizaron 52 citas seleccionadas para realizar la revisión, 46 de ellas de los últimos cinco años donde se incluyeron dos libros.
Desarrollo: se analizaron diferentes factores para decisión del tipo del tratamiento, entre los que se encontraron: la escala de severidad de las fracturas del segmento lumbosacro propuesta por Vaccaro AR, los grados de cifosis, la usurpación del canal medular. Por otra parte se realizó una comparación de diferentes autores en relación al tipo de tratamiento empleado en sus investigaciones y las indicaciones quirúrgicas para sus pacientes.
Conclusiones: basado en la revisión realizada y los estudios consultados, los pacientes con fractura de columna sin lesión neurológica pueden ser tratados de forma conservadora independientemente del grado de inestabilidad mecánica que presenten.
Background: fractures of the spine by axial compression mechanism without neurological lesion are a paradigm in connection with its conservative or surgical treatment. There is controversy in the litera-ture about the type of treatment of this lesion.
Objective: to make a review about the selection criteria of both types of treatment.
Methods: a bibliographic review of 330 articles published in Pubmed, Hinari and Medline by means of the reference management software Endnote was made. Fifty-two citations were selected for the review, 46 of them from the last five years; two books were included.
Development: different factors for deciding the type of treatment were analysed. Some of the fac-tors were the following: severity scale of the fractures of the lumbosacral segment proposed by Vaccaro AR, kyphosis degree, and medullary channel. On the other hand, a comparison of different authors was made according to the treatment applied in their researches and the surgical indications for their patients.
Conclusions: according to the review made and the studies consulted, the patients with fractures of the spine without neurological lesion can be treated conservatively in spite of the degree of mechanical instability they present.
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22 julio 2025