Precisión del neuromonitoreo intraoperatorio durante la discoplastia percutánea con cemento
DOI:
https://doi.org/10.31053/1853.0605.v78.n3.32619Palabras clave:
escoliosis, dolor de espalda, enfermedades de la columna vertebralResumen
Introducción: La Discoplastia percutánea con cemento es un procedimiento mínimamente invasivo para tratar el dolor lumbar debido a la enfermedad degenerativa del disco avanzada en pacientes ancianos. Se han descrito complicaciones de este procedimiento como infección, fractura vertebral, fuga de cemento y lesión nerviosa. El neuromonitoreo intraoperatorio se utiliza para detectar este último. El objetivo de este estudio fue evaluar la utilidad del neuromonitoreo intraoperatorio durante la Discoplastia para detectar un nuevo compromiso neurológico.
Materiales y Métodos: se incluyeron en este estudio retrospectivo 100 pacientes consecutivos (30 varones y 70 mujeres, edad media 76,3 ± 5,71 años) con lumbalgia mecánica sometidos a Discoplastia percutánea con cemento.
Resultados: La sensibilidad para detectar lesión neurológica fue del 82% (IC 95% 66-98), la especificidad fue del 99% (IC 95% 98-100) con un valor predictivo positivo de 0,95 (IC 95% 85-100) y un valor predictivo negativo. valor predictivo de 0,97 (IC 95% 95-99). En 5 pacientes no se detectó compromiso neurológico mediante neuromonitoreo.
Discusión: Nuestro estudio mostró una alta sensibilidad y especificidad del neuromonitoreo intraoperatorio para detectar irritación neurológica durante la discoplastia percutánea. El neuromonitoreo intraoperatorio resultó una ayuda eficaz durante este procedimiento mínimamente invasivo.
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