array:23 [
  "pii" => "S169540330178664X"
  "issn" => "16954033"
  "doi" => "10.1016/S1695-4033(01)78664-X"
  "estado" => "S300"
  "fechaPublicacion" => "2001-02-01"
  "aid" => "78664"
  "copyright" => "Asociación Española de Pediatría"
  "copyrightAnyo" => "2001"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "An Pediatr (Barc). 2001;54:126-31"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 14247
    "formatos" => array:3 [
      "EPUB" => 76
      "HTML" => 13253
      "PDF" => 918
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1695403301786651"
    "issn" => "16954033"
    "doi" => "10.1016/S1695-4033(01)78665-1"
    "estado" => "S300"
    "fechaPublicacion" => "2001-02-01"
    "aid" => "78665"
    "copyright" => "Asociación Española de Pediatría"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "An Pediatr (Barc). 2001;54:132-5"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 8671
      "formatos" => array:3 [
        "EPUB" => 64
        "HTML" => 8071
        "PDF" => 536
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Tratamiento endoscópico del reflujo vesicoureteral"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "132"
          "paginaFinal" => "135"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Endoscopic treatment of vesicoureteral reflux"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J.A. López López, J.M. Sánchez Zalabardo, M.A. Sánchez Elipe, J.G. Valdivia Uría, J. Valle Gerhold, A. Jiménez Vidal"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "J.A."
              "apellidos" => "López López"
            ]
            1 => array:2 [
              "nombre" => "J.M."
              "apellidos" => "Sánchez Zalabardo"
            ]
            2 => array:2 [
              "nombre" => "M.A."
              "apellidos" => "Sánchez Elipe"
            ]
            3 => array:2 [
              "nombre" => "J.G."
              "apellidos" => "Valdivia Uría"
            ]
            4 => array:2 [
              "nombre" => "J."
              "apellidos" => "Valle Gerhold"
            ]
            5 => array:2 [
              "nombre" => "A."
              "apellidos" => "Jiménez Vidal"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403301786651?idApp=UINPBA00005H"
    "url" => "/16954033/0000005400000002/v1_201307051539/S1695403301786651/v1_201307051539/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1695403301786638"
    "issn" => "16954033"
    "doi" => "10.1016/S1695-4033(01)78663-8"
    "estado" => "S300"
    "fechaPublicacion" => "2001-02-01"
    "aid" => "78663"
    "copyright" => "Asociación Española de Pediatría"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "An Pediatr (Barc). 2001;54:120-5"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 6022
      "formatos" => array:3 [
        "EPUB" => 57
        "HTML" => 5292
        "PDF" => 673
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Colelitiasis en la infancia. Análisis de 24 pacientes y revisión de 123 casos publicados en España"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "120"
          "paginaFinal" => "125"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Childhood cholelithiasis. analysis of 24 patients diagnosed in our department and review of 123 cases published in spain"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J.L. Ruibal Francisco, E. Aleo Luján, A. Álvarez Mingote, E. Piñero Martínez, R. Gómez Casares"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "J.L."
              "apellidos" => "Ruibal Francisco"
            ]
            1 => array:2 [
              "nombre" => "E."
              "apellidos" => "Aleo Luján"
            ]
            2 => array:2 [
              "nombre" => "A."
              "apellidos" => "Álvarez Mingote"
            ]
            3 => array:2 [
              "nombre" => "E."
              "apellidos" => "Piñero Martínez"
            ]
            4 => array:2 [
              "nombre" => "R."
              "apellidos" => "Gómez Casares"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403301786638?idApp=UINPBA00005H"
    "url" => "/16954033/0000005400000002/v1_201307051539/S1695403301786638/v1_201307051539/es/main.assets"
  ]
  "es" => array:13 [
    "idiomaDefecto" => true
    "titulo" => "Estenosis del canal lumbar en la acondroplasia. Prevención y corrección de la lordosis lumbosacra"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "126"
        "paginaFinal" => "131"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; G&#243;mez Prat&#8224;, L&#46; Garc&#237;a Oll&#233;, I&#46; Ginebreda Mart&#237;, J&#46;M&#46;<span class="elsevierStyleSup">a</span> Gair&#237; Tahull, J&#46; Vilarrubias Guillamet"
        "autores" => array:5 [
          0 => array:2 [
            "nombre" => "A&#46;"
            "apellidos" => "G&#243;mez Prat&#8224;"
          ]
          1 => array:2 [
            "nombre" => "L&#46;"
            "apellidos" => "Garc&#237;a Oll&#233;"
          ]
          2 => array:4 [
            "nombre" => "I&#46;"
            "apellidos" => "Ginebreda Mart&#237;"
            "email" => array:1 [
              0 => "iginebreda&#46;icatme&#64;idexeus&#46;es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          3 => array:2 [
            "nombre" => "J&#46;M&#46;<span class="elsevierStyleSup">a</span>"
            "apellidos" => "Gair&#237; Tahull"
          ]
          4 => array:2 [
            "nombre" => "J&#46;"
            "apellidos" => "Vilarrubias Guillamet"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Unidad de Patolog&#237;a del Crecimiento&#46; Institut Universitari Dexeus &#40;ICATME&#41;&#46; Barcelona"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#42;"
            "correspondencia" => "Correspondencia&#58; Dr&#46; I&#46; Ginebreda Mart&#237;&#46; ICATME Iradier&#44; 3&#46; 08017 Barcelona&#46;"
          ]
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "1999-10-01"
    "fechaAceptado" => "2000-08-01"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec186577"
          "palabras" => array:3 [
            0 => "<span class="elsevierStyleItalic">Acondroplasia</span>"
            1 => "<span class="elsevierStyleItalic">Alargamiento</span>"
            2 => "<span class="elsevierStyleItalic">Estenosis del canal lumbar</span>"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec186578"
          "palabras" => array:3 [
            0 => "<span class="elsevierStyleItalic">Achondroplasia</span>"
            1 => "<span class="elsevierStyleItalic">Femoral lengthening</span>"
            2 => "<span class="elsevierStyleItalic">Stenosis of the lumbar canal</span>"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los objetivos de este art&#237;culo fueron determinar&#44; mediante la medici&#243;n de diversos &#225;ngulos&#44; la correcci&#243;n de la hiperlordosis lumbosacra tras un proceso de elongaci&#243;n femoral bilateral seg&#250;n la t&#233;cnica Icatme&#44; as&#237; como la ausencia de s&#237;ntomas neurol&#243;gicos derivados de la estenosis del canal tras el alargamiento femoral&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">En este estudio se incluyeron 34 pacientes acondropl&#225;sicos&#44; con una edad media actual de 22&#44;3 a&#241;os&#44; a los cuales se les ha practicado un alargamiento femoral seg&#250;n la t&#233;cnica Icatme y en los cuales se ha medido&#44; en radiograf&#237;as de perfil de la columna dorsolumbar preelongaci&#243;n y postelongaci&#243;n&#44; toda una serie de &#225;ngulos que se enumeran en el texto&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los resultados obtenidos mostraron una disminuci&#243;n del &#225;ngulo de lordosis lumbar&#44; de Sez&#232; y L5-S1&#44; as&#237; como un aumento de los &#225;ngulos lumbosacro&#44; de Junghans y sacro&#44; que cl&#237;nicamente se traduce en una correcci&#243;n de la hiperlordosis lumbar&#44; verticalizaci&#243;n del sacro y mejora de la inflexi&#243;n toracolumbar y lumbosacra&#44; acerc&#225;ndose a los valores promedio est&#225;ndar para los individuos no acondropl&#225;sicos&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La est&#225;tica de la columna lumbar del paciente acondropl&#225;sico se modifica tras un proceso de elongaci&#243;n femoral bilateral &#40;t&#233;cnica Icatme&#41;&#44; que se acercan a los valores est&#225;ndar de los individuos sin acondroplasia&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Tras un proceso de alargamiento de f&#233;mures seg&#250;n la t&#233;cnica Icatme se consigue una correcci&#243;n de la hiperlordosis lumbar con la cual se previene la aparici&#243;n de sintomatolog&#237;a neurol&#243;gica derivada de la estenosis del canal&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La incidencia de complicaciones neurol&#243;gicas derivadas de la estenosis del canal lumbar es baja respecto a los individuos acondropl&#225;sicos sin elongaci&#243;n para iguales grupos de edad y sexo&#46;</p>"
      ]
      "en" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To determine through the measurement of different angles the correction of lumbar hyperlordosis after bilateral femoral lengthening using the Icatme technique and to assess the absence of neurological symptomatology secondary to stenosis of the lumbar canal after femoral lengthening&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Thirty-four patients with achondroplasia were studied&#46; Mean age was 22&#46;3 years&#46; The patients underwent femoral lengthening using the Icatme technique&#46; X-rays of the lateral rachis taken before and after lengthening were used to measure a series of angles&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The lumbar lordosis angle&#44; Sez&#232;&#39;s angle and the L5-S1 angle decreased while the lumbosacral angle&#44; Jungham&#39;s angle and the sacrum angle increased&#44; leading to correction of lumbar hyperlordosis&#44; verticalization of the sacrum and improvement in thoracolumbar and lumbosacral inflection&#46; Values were similar to the standard for individuals without achondroplasia&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Femoral lengthening using the Icatme technique in achondroplastics modifies the statics of the lumbar spine&#44; making them similar to those of non-achondroplastics&#46; The procedure corrects lumbar hyperlordosis and prevents the appearance of neurological symptomatology due to stenosis of the lumbar canal&#46; The incidence of neurological complications due to stenosis of the lumbar canal in achondroplastics who have undergone femoral lengthening is low compared with that of achondroplastics of the same age and sex who have not undergone this procedure&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:22 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complicaciones neurol&#243;gicas de la condroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46; De Gispert-Cruz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Clin Esp"
                        "fecha" => "1954"
                        "volumen" => "153"
                        "paginaInicial" => "127"
                        "paginaFinal" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/482677"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neurological considerations in achondroplasia&#46; En&#58; Human Achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "o&#46; Hurko"
                            1 => "R&#46; Pyeritz"
                            2 => "S&#46; Uematsu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:3 [
                        "paginaInicial" => "153"
                        "paginaFinal" => "161"
                        "serieFecha" => "1986"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hydrocephalis in chondrodystrophy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;E&#46; Dandy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Bull Johns Hopkins Hosp"
                        "fecha" => "1921"
                        "volumen" => "32"
                        "paginaInicial" => "5"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Untersuchungen &#252;ber den chondrodystrophischen zwergwuchs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Donath"
                            1 => "A&#46; Vogl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Wien Arch Inn Med"
                        "fecha" => "1925"
                        "volumen" => "10"
                        "paginaInicial" => "1"
                        "paginaFinal" => "44"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Achondroplasia and hypoachondroplasia&#46; Clinical variations and spinal stenosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Wynne-Davis"
                            1 => "W&#46;K&#46; Walsh"
                            2 => "J&#46; Gronley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "1981"
                        "volumen" => "63B"
                        "paginaInicial" => "508"
                        "paginaFinal" => "515"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Significance of the small lumbar spinal canal&#58; cauda equina compression due to spondylosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46; Alexander"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurosurg"
                        "fecha" => "1969"
                        "volumen" => "31"
                        "paginaInicial" => "513"
                        "paginaFinal" => "519"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anatomy of the achondroplastic lumbar canal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;D&#46; Lutter"
                            1 => "J&#46;E&#46; Lonstein"
                            2 => "R&#46;B&#46; Winter"
                            3 => "L&#46;O&#46; Langer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop"
                        "fecha" => "1977"
                        "volumen" => "126"
                        "paginaInicial" => "139"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/598103"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal disorders of dwarfism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Bethem"
                            1 => "R&#46;B&#46; Winter"
                            2 => "L&#46; Lutter"
                            3 => "J&#46;H&#46; Moe"
                            4 => "D&#46;S&#46; Bradford"
                            5 => "J&#46;E&#46; Lonstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "1981"
                        "volumen" => "63A"
                        "paginaInicial" => "1412"
                        "paginaFinal" => "1425"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lesions of the spinal cord &#40;transverse myelopathy&#41; in achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Vogl"
                            1 => "R&#46;I&#46; Osborne"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Neurol Psychiatr"
                        "fecha" => "1949"
                        "volumen" => "61"
                        "paginaInicial" => "644"
                        "paginaFinal" => "662"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thoraco-lumbar kiphosis and lumbosacral hyperlordosis in achondroplastic children&#46; En&#58; Human Achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;E&#46; Kopits"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:3 [
                        "paginaInicial" => "241"
                        "paginaFinal" => "260"
                        "serieFecha" => "1986"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anathomy of the lumbar spine in achondroplasia&#46; En&#58; Human Achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;C&#46; Giglio"
                            1 => "R&#46; Passariello"
                            2 => "G&#46; Pagnota"
                            3 => "N&#46; Crostelli"
                            4 => "E&#46; Ascani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:3 [
                        "paginaInicial" => "227"
                        "paginaFinal" => "240"
                        "serieFecha" => "1986"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Curves of the achondroplastic spine&#58; a new hypothesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;A&#46; Siebens"
                            1 => "D&#46;S&#46; Hungerford"
                            2 => "N&#46;A&#46; Kirby"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Johns Hopkins Med Journal"
                        "fecha" => "1978"
                        "volumen" => "142"
                        "paginaInicial" => "205"
                        "paginaFinal" => "210"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lengthening of the lower limbs and correction of lumbar hyperlordosis in achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Vilarrubias"
                            1 => "I&#46; Ginebreda"
                            2 => "E&#46; Jimeno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop"
                        "fecha" => "1990"
                        "volumen" => "250"
                        "paginaInicial" => "143"
                        "paginaFinal" => "149"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2293921"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Orthopaedic complications of dwarfism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;E&#46; Kopits"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop"
                        "fecha" => "1976"
                        "volumen" => "114"
                        "paginaInicial" => "153"
                        "paginaFinal" => "179"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/816586"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal stenosis in achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;A&#46; Nelson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "1970"
                        "volumen" => "52"
                        "paginaInicial" => "1285"
                        "paginaFinal" => "1288"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5472902"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The surgical treatement of vertebral deformities en achondroplastic dwarfism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Parisini"
                            1 => "T&#46; Greggi"
                            2 => "R&#46; Casadei"
                            3 => "A&#46; Martini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chir Organi Mov"
                        "fecha" => "1996"
                        "volumen" => "81"
                        "paginaInicial" => "129"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8968116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Orthopaedic aspects of achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;A&#46; Bailey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bone Joint Surg"
                        "fecha" => "1970"
                        "volumen" => "52A"
                        "paginaInicial" => "1285"
                        "paginaFinal" => "1301"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The clinical spectrum of lumbar spine disease in achondroplasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Kahanovitz"
                            1 => "D&#46;L&#46; Rimoin"
                            2 => "D&#46;O&#46; Sillence"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Spine"
                        "fecha" => "1982"
                        "volumen" => "7"
                        "paginaInicial" => "137"
                        "paginaFinal" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7089690"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intermittent claudication of the cauda equina&#46; An unusual syndrome resulting from central protrusion of a lumbar intervertebral discs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;N&#46; Blau"
                            1 => "V&#46; Logue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1961"
                        "volumen" => "1"
                        "paginaInicial" => "1081"
                        "paginaFinal" => "1086"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2566033"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Three cases of achondroplasia with neurological complications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;D&#46; Spillane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurol Neurosurg Psychiatr"
                        "fecha" => "1952"
                        "volumen" => "15"
                        "paginaInicial" => "246"
                        "paginaFinal" => "252"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13011653"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Compression of spinal cord and cauda equina in achondroplastic dwarfs"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;A&#46; Epstein"
                            1 => "L&#46;I&#46; Malis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurology&#44;"
                        "fecha" => "1955"
                        "volumen" => "5"
                        "paginaInicial" => "875"
                        "paginaFinal" => "881"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Total craniospinal decompression in achondroplastic stenosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Uematsu"
                            1 => "H&#46; Wang"
                            2 => "O&#46; Kopits"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1994"
                        "volumen" => "35"
                        "paginaInicial" => "250"
                        "paginaFinal" => "257"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7969832"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/16954033/0000005400000002/v1_201307051539/S169540330178664X/v1_201307051539/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "14282"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/16954033/0000005400000002/v1_201307051539/S169540330178664X/v1_201307051539/es/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169540330178664X?idApp=UINPBA00005H"
]
Compartir
Información de la revista
Vol. 54. Núm. 2.
Páginas 126-131 (febrero 2001)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 54. Núm. 2.
Páginas 126-131 (febrero 2001)
Acceso a texto completo
Estenosis del canal lumbar en la acondroplasia. Prevención y corrección de la lordosis lumbosacra
Visitas
20186
A. Gómez Prat†, L. García Ollé, I. Ginebreda Martí
Autor para correspondencia
iginebreda.icatme@idexeus.es

Correspondencia: Dr. I. Ginebreda Martí. ICATME Iradier, 3. 08017 Barcelona.
, J.M.a Gairí Tahull, J. Vilarrubias Guillamet
Unidad de Patología del Crecimiento. Institut Universitari Dexeus (ICATME). Barcelona
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Objetivos

Los objetivos de este artículo fueron determinar, mediante la medición de diversos ángulos, la corrección de la hiperlordosis lumbosacra tras un proceso de elongación femoral bilateral según la técnica Icatme, así como la ausencia de síntomas neurológicos derivados de la estenosis del canal tras el alargamiento femoral.

Pacientes y métodos

En este estudio se incluyeron 34 pacientes acondroplásicos, con una edad media actual de 22,3 años, a los cuales se les ha practicado un alargamiento femoral según la técnica Icatme y en los cuales se ha medido, en radiografías de perfil de la columna dorsolumbar preelongación y postelongación, toda una serie de ángulos que se enumeran en el texto.

Resultados

Los resultados obtenidos mostraron una disminución del ángulo de lordosis lumbar, de Sezè y L5-S1, así como un aumento de los ángulos lumbosacro, de Junghans y sacro, que clínicamente se traduce en una corrección de la hiperlordosis lumbar, verticalización del sacro y mejora de la inflexión toracolumbar y lumbosacra, acercándose a los valores promedio estándar para los individuos no acondroplásicos.

Conclusiones

La estática de la columna lumbar del paciente acondroplásico se modifica tras un proceso de elongación femoral bilateral (técnica Icatme), que se acercan a los valores estándar de los individuos sin acondroplasia.

Tras un proceso de alargamiento de fémures según la técnica Icatme se consigue una corrección de la hiperlordosis lumbar con la cual se previene la aparición de sintomatología neurológica derivada de la estenosis del canal.

La incidencia de complicaciones neurológicas derivadas de la estenosis del canal lumbar es baja respecto a los individuos acondroplásicos sin elongación para iguales grupos de edad y sexo.

Palabras clave:
Acondroplasia
Alargamiento
Estenosis del canal lumbar
Objective

To determine through the measurement of different angles the correction of lumbar hyperlordosis after bilateral femoral lengthening using the Icatme technique and to assess the absence of neurological symptomatology secondary to stenosis of the lumbar canal after femoral lengthening.

Patients and methods

Thirty-four patients with achondroplasia were studied. Mean age was 22.3 years. The patients underwent femoral lengthening using the Icatme technique. X-rays of the lateral rachis taken before and after lengthening were used to measure a series of angles.

Results

The lumbar lordosis angle, Sezè's angle and the L5-S1 angle decreased while the lumbosacral angle, Jungham's angle and the sacrum angle increased, leading to correction of lumbar hyperlordosis, verticalization of the sacrum and improvement in thoracolumbar and lumbosacral inflection. Values were similar to the standard for individuals without achondroplasia.

Conclusions

Femoral lengthening using the Icatme technique in achondroplastics modifies the statics of the lumbar spine, making them similar to those of non-achondroplastics. The procedure corrects lumbar hyperlordosis and prevents the appearance of neurological symptomatology due to stenosis of the lumbar canal. The incidence of neurological complications due to stenosis of the lumbar canal in achondroplastics who have undergone femoral lengthening is low compared with that of achondroplastics of the same age and sex who have not undergone this procedure.

Key words:
Achondroplasia
Femoral lengthening
Stenosis of the lumbar canal
El Texto completo está disponible en PDF
Bibliografía
[1.]
I. De Gispert-Cruz.
Complicaciones neurológicas de la condroplasia.
Rev Clin Esp, 153 (1954), pp. 127-131
[2.]
o. Hurko, R. Pyeritz, S. Uematsu.
Neurological considerations in achondroplasia. En: Human Achondroplasia.
pp. 153-161
[3.]
W.E. Dandy.
Hydrocephalis in chondrodystrophy.
Bull Johns Hopkins Hosp, 32 (1921), pp. 5-10
[4.]
J. Donath, A. Vogl.
Untersuchungen über den chondrodystrophischen zwergwuchs.
Wien Arch Inn Med, 10 (1925), pp. 1-44
[5.]
R. Wynne-Davis, W.K. Walsh, J. Gronley.
Achondroplasia and hypoachondroplasia. Clinical variations and spinal stenosis.
J Bone Joint Surg, 63B (1981), pp. 508-515
[6.]
E. Alexander.
Significance of the small lumbar spinal canal: cauda equina compression due to spondylosis.
Neurosurg, 31 (1969), pp. 513-519
[7.]
L.D. Lutter, J.E. Lonstein, R.B. Winter, L.O. Langer.
Anatomy of the achondroplastic lumbar canal.
Clin Orthop, 126 (1977), pp. 139-142
[8.]
D. Bethem, R.B. Winter, L. Lutter, J.H. Moe, D.S. Bradford, J.E. Lonstein, et al.
Spinal disorders of dwarfism.
J Bone Joint Surg, 63A (1981), pp. 1412-1425
[9.]
A. Vogl, R.I. Osborne.
Lesions of the spinal cord (transverse myelopathy) in achondroplasia.
Arch Neurol Psychiatr, 61 (1949), pp. 644-662
[10.]
S.E. Kopits.
Thoraco-lumbar kiphosis and lumbosacral hyperlordosis in achondroplastic children. En: Human Achondroplasia.
pp. 241-260
[11.]
G.C. Giglio, R. Passariello, G. Pagnota, N. Crostelli, E. Ascani.
Anathomy of the lumbar spine in achondroplasia. En: Human Achondroplasia.
pp. 227-240
[12.]
A.A. Siebens, D.S. Hungerford, N.A. Kirby.
Curves of the achondroplastic spine: a new hypothesis.
Johns Hopkins Med Journal, 142 (1978), pp. 205-210
[13.]
J.M. Vilarrubias, I. Ginebreda, E. Jimeno.
Lengthening of the lower limbs and correction of lumbar hyperlordosis in achondroplasia.
Clin Orthop, 250 (1990), pp. 143-149
[14.]
S.E. Kopits.
Orthopaedic complications of dwarfism.
Clin Orthop, 114 (1976), pp. 153-179
[15.]
M.A. Nelson.
Spinal stenosis in achondroplasia.
J Bone Joint Surg, 52 (1970), pp. 1285-1288
[16.]
P. Parisini, T. Greggi, R. Casadei, A. Martini.
The surgical treatement of vertebral deformities en achondroplastic dwarfism.
Chir Organi Mov, 81 (1996), pp. 129-137
[17.]
J.A. Bailey.
Orthopaedic aspects of achondroplasia.
J Bone Joint Surg, 52A (1970), pp. 1285-1301
[18.]
N. Kahanovitz, D.L. Rimoin, D.O. Sillence.
The clinical spectrum of lumbar spine disease in achondroplasia.
Spine, 7 (1982), pp. 137-140
[19.]
J.N. Blau, V. Logue.
Intermittent claudication of the cauda equina. An unusual syndrome resulting from central protrusion of a lumbar intervertebral discs.
Lancet, 1 (1961), pp. 1081-1086
[20.]
J.D. Spillane.
Three cases of achondroplasia with neurological complications.
J Neurol Neurosurg Psychiatr, 15 (1952), pp. 246-252
[21.]
J.A. Epstein, L.I. Malis.
Compression of spinal cord and cauda equina in achondroplastic dwarfs.
Neurology,, 5 (1955), pp. 875-881
[22.]
S. Uematsu, H. Wang, O. Kopits.
Total craniospinal decompression in achondroplastic stenosis.
Neurosurgery, 35 (1994), pp. 250-257
Copyright © 2001. Asociación Española de Pediatría
Descargar PDF
Idiomas
Anales de Pediatría
Opciones de artículo
Herramientas