Comentario al trabajo

Documento descargado de http://www.revistaneurocirugia.com el 29/11/2016. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato.
1HXURFLUXJtD
0LHUH]\FRO
&RPHQWDULRDOWUDEDMR)UDFWXUDHYROXWLYDGHFUiQHRHQ
ODLQIDQFLD3UHVHQWDFLyQGHFDVRVGH50LHUH]\FROV
6HGHQRPLQDIUDFWXUDHYROXWLYDDXQD¿VXUDFUDQHDOTXH
FRQWLQ~DH[SDQGLpQGRVHFRQHOWUDQVFXUVRGHOWLHPSR(VWD
HQWLGDGVHYHGHPDQHUDFDVLH[FOXVLYDHQQLxRVSHTXHxRV
(O'U0LHUH]\FRODERUDGRUHVOODPDQQXHVWUDDWHQFLyQDQWH
HVWDHQWLGDGFRQXQDVHULHGHGRFHQLxRVFRQIUDFWXUDVHYR
OXWLYDVGHOFUiQHR6HWUDWDGHXQDFDVXtVWLFDLPSRUWDQWHVL
WHQHPRVHQFXHQWDODUDUH]DGHHVWRVSURFHVRV
/RVUHTXLVLWRVLQGLVSHQVDEOHVSDUDODIRUPDFLyQGHXQD
IUDFWXUDHYROXWLYDVRQODSUHVHQFLDGHXQDIUDFWXUDFUD
QHDOMXQWRFRQXQDKHULGDGHODGXUDPDGUH3UREDEOH
PHQWHWDPELpQHVQHFHVDULDODVDOLGDGHWHMLGRDUDFQRLGHR
D WUDYpV GH OD ¿VXUD yVHD 6LQ HPEDUJR H[LVWH XQD FLHUWD
FRQWURYHUVLDVREUHVLHVLPSUHVFLQGLEOHRQRTXHKD\DXQD
OHVLyQ FHUHEUDO EDMR OD IUDFWXUD FRQWXVLyQ KHPRUUiJLFD
HGHPDIRFDOHWF5HFLHQWHPHQWHVHKDGHVFULWRXQDKLSy
WHVLV SDWRJHQpWLFD FRP~Q SDUD H[SOLFDU HO FUHFLPLHQWR GH
ODIUDFWXUDFUDQHDOHYROXWLYDODIRUPDFLyQGHHQFHIDORFHOHV
SRVWWUDXPiWLFRV\ODH[SDQVLyQGHORVHQFHIDORFHOHVFRQJp
QLWRV(VWDWHRUtDVXSRQHHOSDSHOGHXQDIXHU]DH[SDQVLYD
ELHQVHDHOLPSXOVRQRUPDOGHOFHUHEURHQGHVDUUROORGHORV
QLxRVRHODXPHQWRGHODSUHVLyQLQWUDFUDQHDOHQFDVRVGH
OHVLRQHVWUDXPiWLFDVKLGURFHIDOLDHGHPDHWF(QQLxRV
PX\ SHTXHxRV HO IDFWRU TXH FRQGXFH D OD VHSDUDFLyQ GH
ORVERUGHVGHODIUDFWXUDHYROXWLYDSRGUtDHVWDUFRQVWLWXLGR
SRUODVSXOVDFLRQHVQRUPDOHVGHOFHUHEURHQFUHFLPLHQWR
&XULRVDPHQWH ODV IUDFWXUDV HYROXWLYDV \ RWUDV HQWLGDGHV
UHODFLRQDGDV FRPR HO HQFHIDORFHOH SRVWWUDXPiWLFR VH
KDQ GHVFULWR WUDV DFFLGHQWHV \ FRPR FRPSOLFDFLyQ GH
ODFLUXJtDGHODVFUDQHRVLQRVWRVLVSHURQRVHYHQQXQFD
HQODVFUDQHRWRPtDVUHDOL]DGDVHQQLxRVD~QFXDQGRQRVH
KD\D FHUUDGR OD GXUDPDGUH FRPSOHWDPHQWH (Q HO DGXOWR
ORVGHIHFWRVyVHRVSRVWWUDXPiWLFRVVXHOHQFXUVDUFRQXQD
GHSUHVLyQ HQ OD ]RQD GH OD FUDQLHFWRPtD D PHQRV TXH VH
DVRFLHQ D HGHPD R KLGURFHIDOLD YLpQGRVH HQWRQFHV XQD
VDOLGDGHORVWHMLGRVDWUDYpVGHOGHIHFWRFUDQHDO
/DVLQGLFDFLRQHVGHLQWHUYHQFLyQTXLU~UJLFDVRQOD
SUHYHQFLyQGHOGDxRQHXUROyJLFRHQIRUPDGHKHPLSDUHVLD
RFULVLVFRQYXOVLYDVHOFLHUUHGHXQGHIHFWRyVHRVLWXDGR
HQ]RQDVYLVLEOHVFRPRHVODIUHQWHSRUUD]RQHVHVWpWLFDV\
ODSURWHFFLyQGHOFHUHEURDQWHODSRVLELOLGDGGHQXHYRV
WUDXPDWLVPRV&XDQGRYHPRVDORVQLxRVFRQXQDIUDFWXUD
HYROXWLYD FUDQHDO GH ERUGHV HYHUWLGRV \ GXURV FRQ SRFD
VHSDUDFLyQ \ TXH QR SUHVHQWDQ QLQJ~Q VtQWRPD QHXUROy
JLFRRWUDRSFLyQGHWUDWDPLHQWRHVODDEVWHQFLyQGHFLUXJtD
&RPSDUWLPRVWRWDOPHQWHODVSUHIHUHQFLDVGHORVDXWRUHVHQ
FXDQWRDOHPSOHRGHWHMLGRVDXWROyJRVWDQWRSDUDODSODVWLD
GXUDO IDVFLD R SHULRVWLR FRPR SDUD OD FUDQHDO XWLOL]DQGR
IUDJPHQWRVDG\DFHQWHVGHKXHVR
(VGHUHVDOWDUHQHVWHPDJQt¿FRWUDEDMRODGHVFULSFLyQ
GH XQ UHFLpQ QDFLGR TXH SUHVHQWy XQD GH HVWDV IUDFWXUDV
WUDVKDEHUVXIULGRXQWUDXPDWLVPRFUDQHDOGHQWURGHO~WHUR
PDWHUQR
7DPELpQVRQGHGHVWDFDUORVFDVRVGHIUDFWXUDHYROXWLYD
HQUHJLRQHVWHPSRUDO\IURQWDOTXHVRQUHDOPHQWHH[FHS
FLRQDOHV/DVLPiJHQHVVRQH[FHOHQWHV\ODGLVFXVLyQVHULD
\DFHUWDGD6HHFKDGHPHQRVXQDWDEODFRQORVGDWRVFOtQL
FRVGHORVGRFHSDFLHQWHV
-XDQ)0DUWtQH]/DJH
0XUFLD
%LEOLRJUDItD
0DUWtQH]/DJH-)/ySH])3LTXHUDV33R]D0
ODWURJHQLF LQWUDGLSORLF PHQLQJRHQFHSKDORFHOH - 1HXURVXUJ
0DUWtQH]/DJH-)0DUWtQH]3pUH]0'RPLQJR5
3R]D03RVWWUDXPDWLFLQWUDGLSORLFDUDFKQRLGF\VWRIWKHSRV
WHULRUIRVVD&KLOGV1HUY6\VW
5RGUtJXH]&RVWD73DVFXDO&DVWURYLHMR,)UDFWXUDV
HYROXWLYDV GHO FUiQHR 6XV DVSHFWRV FOtQLFRV UDGLROyJLFRV \
HYROXWLYRVHQRFKRFDVRV%RO6RF3HGLDWU0DGU
9LOODUHMR ) 3DVFXDO&DVWURYLHMR O 'DEGRXG &
%RUGHV 0 -RYHU 3 )UDFWXUD HYROXWLYD GHO FUiQHR LDWURJp
QLFD$Q(VS3HGLDWU