Discectomía simple y discectomía más fusión con discos de polimetilmetacrilato para el tratamiento de la hernia discal cervical / Simple discectomy and discectomy plus fusion with polymethylmethacrylate discs for the treatment of cervical herniated disc

Objetivo: Comparar los resultados entre la discectomía más fusión con injertos dediscos de polimetilmetacrilato y la discectomía simple para el tratamiento quirúrgico de la hernia discal cervical.Métodos: Se realizó un estudio caso-control. Se conformaron dos grupos con pacientes operados por hernia discal cervical. En el grupo I (estudio) se incluyeron 131 pacientesa los que se les realizó discectomía más fusión con discos de polimetilmetacrilato en el período entre enero de 2007 y diciembre de 2017. En el grupo II (control histórico), se incluyeron 131 pacientes a los que se les realizó discectomía simple en el períodocomprendido entre enero de 1996 y diciembre de 2006. Todos fueron intervenidos en el Hospital General Docente “Roberto Rodríguez Fernández”, de Morón, Ciego de Ávila,en el mismo quirófano, con las mismas disponibilidades tecnológicas y por el mismo cirujano principal. A todos los enfermos se les realizó el diagnóstico imagenológico con resonancia magnética; el dolor fue evaluado en el pre- y posoperatorio a través de laEscala Visual Análoga, y los resultados se categorizaron de acuerdo con la escala de Ebelin. Para el análisis de los datos se utilizó la técnica de independencia basada en la distribución de Chi-cuadrado para determinar la presencia de asociación estadísticaentre variables categóricas y, además, se aplicó la prueba de Kolmogorov-Smirnov para comparar las distribuciones de las dos muestras.Resultados: Las manifestaciones radiculares predominaron en ambos grupos, 85,5 (Por ciento) en el grupo I y 83,97 (Por ciento) en el grupo II. En el grupo I predominó la afectación de dos omás espacios, mientras que en el grupo II predominó la afectación de un solo espacio...(AU)

Introduction: To compare the results between discectomy plus fusion withpolymethylmethacrylate disc grafts and simple discectomy for the surgical treatment of cervical disc herniation.Methods: A case-control study was carried out. Two groups were formed with patients operated on for cervical disc herniation. Group I (study) included 131 patients who underwent discectomy plus fusion with polymethylmethacrylate discs from January 2007 to December 2017. In group II (historical control), 131 patients were included.They had undergone simple discectomy from January 1996 to December 2006. All of them were operated on at Roberto Rodríguez Fernández Teaching General Hospital in Morón, Ciego de Ávila, in the same operating room, with the same technological availabilities and by the same principal surgeon. All patients were diagnosed with magnetic resonance imaging; the pain was evaluated in the pre- and postoperativeperiod through the Visual Analogue Scale, and the results were categorized according to Ebelin scale. For data analysis, the independence technique based on Chi-square distribution was used to determine the presence of statistical association betweencategorical variables and, in addition, Kolmogorov-Smirnov test was applied tocompare the distributions of the two samples.Results: The radicular manifestations predominated in both groups, 85.5 (Per cent) in group I and 83.97 (Per cent) in group II. In-group I, the involvement of two or more spaces predominated, while in-group II the involvement of only one space predominated....(AU)

Endoscopic evacuation of spontaneous supratentorial intracerebral hemorrhage

Introduction: Spontaneous intracerebral hemorrhage (SICH) constitutes a major public health problem worldwide, despite active research it is still a leading cause of morbidity, disability, and death. In Cuba cerebrovascular disease represents the 3rd cause of death and in the last decade, the number of deaths for this cause has increased and the mortality rate is about 41/100,000/year. Method: We have carried out a descriptive study of 14 patients admitted in the intensive care unit of Moron General Hospital in Ciego de Avila, Cuba, with diagnosis of Spontaneous Supratentorial Intracerebral Hemorrhage (SSICH), who were treated with endoscopic surgical evacuation in the period from January of 2013 to December of 2014. Results: All patients underwent surgery within 12 hours of ictus and 10 (71.43 percent) underwent surgery within 6 hours. The mean time from SSICH onset to surgery was 7.6 hours. The mean operative time was 90 minutes. Endoscopy was successfully completed in all cases and the hematoma evacuation rate was 97 percent- 100 percent in all patients. The mortality rate was 5 patients (35.71 percent). Six months after clot endoscopic evacuation, six cases (42.86 percent) had poor results (Grade IV-VI) and 8 (57.14 percent) had goodrecovery (Grade 0-III). Conclusions: Early endoscope-assisted SSICH evacuation is safe, effective and feasible method in hematoma evacuation.