Palabras clave
Rizotomía dorsal selectiva
Histopatología
Parálisis cerebral
Microcefalia
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Resumen
Objetivo: Analizar los cambios histopatológicos en nervios sensitivos de pacientes con espasticidad sometidos a rizotomía dorsal selectiva, comparando perfiles inflamatorios y degenerativos entre casos de parálisis cerebral y microcefalia asociada al virus del Zika, e investigando correlaciones con parámetros clínico-funcionales. Metodos: Estudio observacional, transversal y analítico con 8 pacientes (4 con parálisis cerebral y 4 con microcefalia). Se recogieron muestras de nervios sensitivos durante la cirugía y se analizaron histopatológicamente para identificar procesos inflamatorios y degenerativos. Los pacientes fueron evaluados mediante GMFCS, GMFM y Escala de Ashworth Modificada. Resultados: Se hallaron cambios degenerativos en el 100% de las muestras e inflamatorios en el 62,5%. Hubo fuerte correlación positiva entre inflamación y degeneración (rs = 0,78; p = 0,023). Pacientes con parálisis cerebral presentaron puntuaciones GMFM superiores a los con microcefalia, especialmente en dimensiones A (Acostarse y Rodar) y B (Sentarse). No se detectaron diferencias significativas en hallazgos histopatológicos entre grupos ni correlaciones con parámetros funcionales. Conclusión: El estudio evidenció degeneración universal en nervios sensitivos de pacientes con espasticidad, independientemente de la etiología, y fuerte relación con inflamación. Aunque no se observó asociación con función motora, los hallazgos sugieren posibles objetivos para estrategias terapéuticas neuroprotectoras.
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