Revisión a largo plazo de fusión lumbar con técnica de Albee: A propósito de 4 casos

Se ha realizado una revisión a largo plazo de 4 pacientes a los que se les practicó una artrodesis vertebral según técnica de Albee. La etiología de la fusión fueron 2 casos de fractura vertebral y 2 casos de escoliosis. Todos los pacientes se reincorporaron a sus actividades habituales. Precisaron nueva consulta médica tras un tiempo medio de 35 años. Dos pacientes desarrollaron estenosis de canal, otro una pseudoartrosis de injerto que cursó con lumbalgia y el restante cursó con lumbociatalgia por espondiloartrosis. Precisaron cirugía secundaria 3 de ellos. La elasticidad anterior que permite la artrodesis de Albee parece ser la responsable del estrechamiento del disco invertebral con aparición de estenosis de canal medular, así como de la menor persistencia de clínica lumbar tras su utilización en comparación con otras técnicas que confieren mayor rigidez.We present a long term retrospective study of 4 patients who were treated by vertebral fusion with Albee's technique. The etiology was vertebral fracture in 2 cases and scoliosis in 2 cases. All patients returned to their previous activity level. Follow-up assessment to their previous activity level. Follow-up assessment was done at a mean of 35 years. At this time, two patients developed spinal stenosis, one a psuedoarthrosis of the cortical bone graft and one showed degenerative disease with back pain. Three cases required a second surgical treatment. Spinal fusion with the Albee's method allows anterior elasticity that could be responsible of vertebral space narrowing and a spinal stenosis. This elasticity also allows a better relief of local symptoms as compared to move rigid techniques

Run Away or Stick Together? The Impact of Organization-Specific Adverse Events on Alliance Partner Defection

Alliances are inter-organizational relationships wherein partners agree to engage in joint action and share benefits and burdens. But when might an adverse event that strikes one partner become too burdensome for another partner? Extant theories of alliance instability provide incomplete answers, which is problematic: for stricken organizations, anticipating whether their non-stricken partners will remain in the alliance can be essential for survival. Integrating insights from alliance dynamics and organizational stigma literatures, we theorize how an organization-specific adverse event affects a non-stricken partner's decision to continue with or defect from an alliance by considering factors that shift the balance between cohesive and disruptive forces. We propose that high stigmatization risk will increase the probability of partner defection through two disruptive mechanisms: relational uncertainty and stigma anxiety. Building on the idea that the same factors contributing to alliance formation may also condition partner defection, we theorize about the roles of partner resource interdependencies, relational embeddedness, and perceived partner similarity in amplifying or attenuating disruptive mechanisms triggered by an adverse event. We extend the research on partner defection and alliance instability by advancing an event-based view of alliance instability and specifying the conditions under which an alliance partner might defect