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La etiología de las deformidades espinales
1University Department of Orthopaedic Surgery, St James's University Hospital, Leeds.
Lancet (London, England)
|May 21, 1988
Resumen
Las deformidades espinales como la lordosis y la cifosis se desarrollan debido a factores biológicos y mecánicos. La reducción de la carga espinal puede promover la progresión de estas afecciones, siendo los factores neuromusculares secundarios en la escoliosis idiopática.
Área de la Ciencia:
- Ortopedia y Biomecánica.
- Biología del desarrollo Biología del desarrollo.
Sus antecedentes:
- Las deformidades de la columna vertebral, específicamente la lordosis y la cifosis, son condiciones distintas.
- La lordosis es rotacionalmente inestable, lo que lleva a una escoliosis secundaria, mientras que la cifosis es una deformidad uniplanar estable.
- El equilibrio de la columna sagital es delicado, por lo que los adolescentes son susceptibles a desarrollar tanto escoliosis idiopática como cifosis.
Objetivo del estudio:
- Aclarar los fundamentos biológicos y mecánicos del desarrollo y la progresión de la deformidad espinal.
- Para diferenciar los comportamientos biomecánicos de la lordosis y la cifosis.
- Aclarar el papel de los factores neuromusculares en la escoliosis idiopática.
Principales métodos:
- Análisis comparativo de la biomecánica de la lordosis y la cifosis.
- Revisión de los principios biológicos y mecánicos que rigen el crecimiento y la estabilidad de la columna vertebral.
- Examen de los factores etiológicos en las deformidades espinales en adolescentes.
Principales resultados:
- La lordosis exhibe inestabilidad rotacional, causando doblamiento y deformidades secundarias del plano transversal (escoliosis).
- La cifosis se presenta como una deformidad uniplanar que no se curva.
- La reducción de la carga crítica en la columna vertebral es un factor clave que favorece el desarrollo y la progresión de la deformidad espinal.
- Las influencias neuromusculares se consideran aditivas en lugar de causativas en la escoliosis idiopática.
Conclusiones:
- Las deformidades espinales surgen de una compleja interacción de factores biológicos y mecánicos.
- Comprender la biomecánica distinta de la lordosis y la cifosis es crucial para el diagnóstico y el manejo.
- Los factores que reducen la carga espinal tienen un impacto significativo en la progresión de la deformidad, y los factores neuromusculares juegan un papel secundario en la escoliosis idiopática.
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