Quilotórax tras abordaje anterior de columna toracolumbar. Revisión bibliográfica a propósito de un caso / Chylothorax following anterior thoraco-lumbar spine exposure. A case report and review of literature

El derrame pleural es una de las posibles complicaciones del abordaje toracoabdominal de la columna. Lo más frecuente es que se trate de una efusión reactiva, pero entre sus causas posibles se encuentran el hemotórax, el empiema o, con menor frecuencia, el quilotórax. Presentamos un caso de quilotórax como complicación tardía de una artrodesis instrumentada de columna lumbar mediante doble abordaje, su manejo y evolución clínica, y una revisión de la bibliografía (AU)

Pleural effusion is a possible complication of the thoraco-abdominal approach to the spine. It is more commonly a reactive effusion, but it also may be caused by hemothorax, empyema or, less commonly, a chylothorax. The case of a chylothorax is reported as a late onset complication of a double anterior and posterior instrumented fusion of the lumbar spine. Its management and clinical outcome, and a review of the literature is presented (AU)

Chylothorax following anterior thoraco-lumbar spine exposure. A case report and review of literature.

Pleural effusion is a possible complication of the thoraco-abdominal approach to the spine. It is more commonly a reactive effusion, but it also may be caused by hemothorax, empyema or, less commonly, a chylothorax. The case of a chylothorax is reported as a late onset complication of a double anterior and posterior instrumented fusion of the lumbar spine. Its management and clinical outcome, and a review of the literature is presented.

Espondilolisis y espondilolistesis en niños y adolescentes / Spondylolysis and spondylolisthesis in children and adolescents

El dolor lumbar es causa frecuente de cese de actividades deportivas en atletas jóvenes, y la espondilolisis es su causa identificable más común. Aunque los avances en las técnicas radiológicas permiten su diagnóstico en fases precoces, en algunos casos la progresión a espondilolistesis es asintomática y no se detecta hasta fases avanzadas. No hay consenso en el objetivo del tratamiento, que consiste en la resolución clínica, radiológica, biomecánica o funcional, según autores. También hay falta de acuerdo en el tratamiento conservador ideal, en las indicaciones quirúrgicas y en la necesidad de reducción de la espondilolistesis, y muchas recomendaciones establecidas no están avaladas por la evidencia. Presentamos una revisión de la bibliografía que resume el conocimiento actual de la espondilolisis y espondilolistesis en niños y adolescentes (AU)

Low back pain is a common cause of lost playing time in young athletes, and spondylolysis is its most common identifiable cause. Despite technological advances in radiology, which can lead to an early diagnosis with better prognosis, progression to spondylolisthesis is sometimes asymptomatic and may not be detected until late stages. There are wide variations, suggesting lack of consensus as regards the objective of treatment, which consists of clinical, radiological, biomechanical or functional improvement. There is also a lack of agreement regarding the ideal conservative treatment, surgical indications and need of slip reduction, and most of the established recommendations are not evidence based. We present a review of literature, which summarizes the current knowledge of spondylolysis and spondylolisthesis in children and adolescents (AU)

[Spondylolysis and spondylolisthesis in children and adolescents]. / Espondilolisis y espondilolistesis en niños y adolescentes.

Low back pain is a common cause of lost playing time in young athletes, and spondylolysis is its most common identifiable cause. Despite technological advances in radiology, which can lead to an early diagnosis with better prognosis, progression to spondylolisthesis is sometimes asymptomatic and may not be detected until late stages. There are wide variations, suggesting lack of consensus as regards the objective of treatment, which consists of clinical, radiological, biomechanical or functional improvement. There is also a lack of agreement regarding the ideal conservative treatment, surgical indications and need of slip reduction, and most of the established recommendations are not evidence based. We present a review of literature, which summarizes the current knowledge of spondylolysis and spondylolisthesis in children and adolescents.

Sacroileítis piógena en el niño y el adulto joven. A propósito de tres casos / Pyogenic sacroiliitis in the child and young adult. Three case reports

La sacroileítis piógena es una patología inusual que supone menos del 2% del total de las artritis sépticas y constituye un reto diagnóstico para el clínico debido a la diversidad de manifestaciones clínicas, la baja especificidad de las pruebas analíticas y la limitación de la radiología simple en fases precoces, lo que retarda el establecimiento de una antibioterapia precoz, que ha demostrado ser el tratamiento de elección en estos pacientes. Su diferente fisiopatología en el niño la transforma en una entidad diferenciada de la del adulto. Presentamos tres casos de sacroileítis séptica en la edad infanto-juvenil, de los cuáles dos evolucionaron favorablemente con tratamiento médico y uno precisó tratamiento quirúrgico con complicaciones postoperatorias (AU)

Pyogenic sacroiliitis is a rare condition with prevalence of septic arthritis lower than 2%, and represents a diagnostic challenge for clinicians due to the variety of clinical expressions, low analytic specificity and the limitations of simple x-rays in the early stages, leading to delayed antibiotic therapy which is the treatment of choice for these patients. The inherent characteristics of its pathophysiology in children makes it distinguishable from that in adults.We report three cases of children and adolescents, two of whom improved clinically after medical treatment, and one required surgical debridement with a postoperative complication (AU)