{"id":15062,"date":"2026-03-20T00:00:53","date_gmt":"2026-03-19T23:00:53","guid":{"rendered":"https:\/\/dev.institutchiaribcn.com\/enfermedades\/platibasia\/"},"modified":"2026-03-30T12:37:04","modified_gmt":"2026-03-30T10:37:04","slug":"platibasia","status":"publish","type":"enfermedades","link":"https:\/\/institutchiaribcn.com\/ca\/platibasia\/","title":{"rendered":"Platib\u00e0sia"},"content":{"rendered":"

\u00daltima actualitzaci\u00f3: 20\/03\/2026, <\/strong>Dr. Miguel B. Royo Salvador<\/strong><\/a>, N\u00famero de col\u00b7legiat 10389.<\/strong> Neurocirurgi\u00e0 i Neur\u00f2leg.<\/strong><\/p>\n

Definici\u00f3<\/strong><\/h2>\n

Es coneix amb el nom de Platib\u00e0sia (PTB) l’anomalia \u00f2ssia consistent en l\u2018aplanament de la base del crani, que es tradueix en l’obertura de l’angle basal de Boogard. El valor normal d’aquest angle oscil\u00b7la entre 115\u00ba i 140\u00ba. Existeix la platib\u00e0sia quan l’angle supera els 140\u00ba. Tamb\u00e9 poden considerar-se altres angles de refer\u00e8ncia, per exemple el de Bull (normal en 13\u00ba).<\/p>\n

Habitualment aquesta alteraci\u00f3 es presenta associada a la Invaginaci\u00f3 basilar. No obstant aix\u00f2, la Platib\u00e0sia pot presentar-se a\u00efllada, i d’altra banda pot observar-se Invaginaci\u00f3 basilar sense Platib\u00e0sia.<\/p>\n

 <\/p>\n

\n

S\u00edmptomes<\/strong><\/h2>\n

La Platib\u00e0sia a\u00efllada no s’acompanya de s\u00edmptomes i, quan s’observen, sempre hi ha Invaginaci\u00f3 basilar o altres malformacions associades, per exemple la S\u00edndrome d’Arnold Chiari I.<\/p>\n

 <\/p>\n

\n

Causes <\/strong><\/h2>\n
\n

– Segons les teories convencionals:<\/strong><\/p>\n

La causa de la Platib\u00e0sia \u00e9s convencionalment desconeguda.<\/p>\n

– Segons el m\u00e8tode sanitari Filum System\u00ae<\/sup>:<\/strong><\/p>\n

Segons la teoria del Dr. Royo Salvador, la Platib\u00e0sia \u00e9s deguda a un mecanisme cong\u00e8nit d\u2019asincronia en el creixement, en fase embrion\u00e0ria, de la medul\u00b7la i de la columna. Per motiu de la seva causa – una for\u00e7a de tracci\u00f3 medul\u00b7lar an\u00f2mala que es transmet des del sacre, pel filum terminale i fins a la massa encef\u00e0lica -, pot determinar una alteraci\u00f3 en el v\u00e8rtex de l’angle basal de l’enc\u00e8fal: en obrir-se aquest, es produeix la Platib\u00e0sia.<\/p>\n<\/div>\n

 <\/p>\n

\n

Malaltia del Filum<\/strong><\/h2>\n

El Dr. Royo Salvador (1992), en la seva tesi doctoral va demostrar que diverses malalties de causa desconeguda, com: s\u00edndrome d’Arnold Chiari I, Siringomi\u00e8lia i Escoliosi idiop\u00e0tiques, Platib\u00e0sia, Impressi\u00f3 Basilar, Retroc\u00e9s odontoide, Angulaci\u00f3 del tronc cerebral, formen part \u2013 compartint la causa; la tracci\u00f3 de la medul\u00b7la espinal i de tot el sistema nervi\u00f3s – d’un nou concepte de patologia, la Malaltia del Filum.<\/p>\n

La for\u00e7a de tracci\u00f3 de tot el sistema nervi\u00f3s en la Malaltia del Filum es presenta en tots els embrions humans, per la qual cosa en major o menor mesura pateixen les seves conseq\u00fc\u00e8ncies i es manifesten de molt diverses formes i intensitats.
\nEn la Malaltia del Filum estan involucrades, pel motiu de la seva causa, altres malalties com les h\u00e8rnies discals vertebrals, algunes s\u00edndromes d’insufici\u00e8ncia vascular cerebral, s\u00edndromes de la faceta articular i de Baastrup, Fibromi\u00e0lgia, Fatiga cr\u00f2nica, Enuresi nocturna, incontin\u00e8ncia urin\u00e0ria i parapar\u00e8sies acusades.<\/p>\n

Per precisar el diagn\u00f2stic i orientar el tractament i el seguiment de la Malaltia del Filum s’ha confeccionat un m\u00e8tode sanitari, el Filum System\u00ae<\/sup>.<\/strong><\/a><\/p>\n

 <\/p>\n

\n

Tomografia axial computada – TAC CRANIAL<\/strong><\/h2>\n

Per al diagn\u00f2stic i control de la Platib\u00e0sia, es visualitza el crani amb una Tomografia axial computada -TAC cranial -.<\/p>\n

Pot passar que algun diagn\u00f2stic es realitzi tamb\u00e9 a trav\u00e9s d’una Resson\u00e0ncia Magn\u00e8tica Nuclear -RMN encef\u00e0lica o cranial -, per\u00f2, una vegada detectada, per a l\u2019\u00f2ptim control de la malformaci\u00f3, s’indica el TAC.<\/p>\n

 <\/p>\n

\"\"<\/div>\n

Fig. 1 Imatge Platib\u00e0sia en un TAC.<\/em><\/p>\n

 <\/p>\n

\"\"<\/div>\n

Fig.2 Imatge de Platib\u00e0sia en una RMN.<\/em><\/p>\n

\n

Factors de risc<\/strong><\/h2>\n

La Platib\u00e0sia \u00e9s una malformaci\u00f3 cong\u00e8nita, de naixement.<\/p>\n

 <\/p>\n

\n

Complicacions<\/strong><\/h2>\n

No s’observa que la Platib\u00e0sia, per si mateixa, comporti complicacions, per\u00f2, quan est\u00e0 associada a Invaginaci\u00f3 Basilar, pot tenir-les.<\/p>\n

 <\/p>\n

\n

Tractament<\/strong><\/h2>\n

Convencionalment, per al diagn\u00f2stic de Platib\u00e0sia no s’indiquen tractaments m\u00e8dics ni neuroquir\u00fargics.<\/p>\n

En canvi, si la Platib\u00e0sia s’acompanya d’altres malformacions de la xarnera cranio-cervical, depenent de quins siguin, es recorre actualment a intervencions neuroquir\u00fargiques molt complexes, invasives i que comporten alt risc de morbiditat i de mortalitat per les seves complicacions (afegides a les de les patologies per les quals s’indiquen).<\/p>\n

Per exemple, si la Platib\u00e0sia es presenta amb la S\u00edndrome d’Arnold Chiari I; es procedeix a craniotomia i descompressi\u00f3 suboccipital, si, per contra, est\u00e0 associada a Invaginaci\u00f3 basilar; es pot aplicar la resecci\u00f3 de les odontoides amb instrumentaci\u00f3 cranio-cervical.<\/p>\n

Des del 1993, amb la publicaci\u00f3 de la tesi doctoral del Dr. Royo Salvador, relacionant la tracci\u00f3 caudal de tot el sistema nervi\u00f3s pel filum terminale, com a causa de la Platib\u00e0sia – entre d\u2019altres malalties -, s’ha dissenyat un nou tractament etiol\u00f2gic, ja que en seccionar quir\u00fargicament el filum terminale s’elimina la for\u00e7a de tracci\u00f3 medul\u00b7lar caudal responsable.
\nSi la Platib\u00e0sia no \u00e9s a\u00efllada i s’acompanya d’Invaginaci\u00f3 Basilar o S\u00edndrome d’Arnold Chiari I o d\u2019altres malalties (que comparteixen la causa de la tracci\u00f3 caudal an\u00f2mala), es recomana la Secci\u00f3 del Filum Terminale segons la t\u00e8cnica pr\u00f2pia i exclusiva, dissenyada i inclosa en el m\u00e8tode del Filum System\u00ae<\/sup>.<\/p>\n

 <\/p>\n

\n

La Secci\u00f3 del Filum Terminale<\/strong><\/h2>\n

 <\/p>\n

\n
\n
\n

Avantatges<\/strong><\/h3>\n

 <\/p>\n

1. Elimina la causa de la Platib\u00e0sia.<\/p>\n

2. Amb la t\u00e8cnica quir\u00fargica m\u00ednimament invasiva pr\u00f2pia de l\u2019ICSEB, el temps quir\u00fargic \u00e9s de 45 minuts. Poques hores d’ingr\u00e9s. Anest\u00e8sia local. Postoperatori curt i sense limitacions. Sense ingr\u00e9s en la Unitat de Vigil\u00e0ncia intensiva. Sense transfusions de sang.<\/p>\n

3. La seva aplicaci\u00f3 suposa el 0% de mortalitat, sense seq\u00fceles.<\/p>\n

4. Millora els s\u00edmptomes i atura l\u2019evoluci\u00f3 en les patologies associades a la Platib\u00e0sia.<\/p>\n<\/div>\n<\/div>\n<\/div>\n

Amb la secci\u00f3 del Filum Terminale s’elimina la tensi\u00f3 de la medul\u00b7la espinal i desapareix la for\u00e7a que generen les curvatures, procedent del Filum Terminale. Per descomptat, la simple secci\u00f3 d’aquest lligament fa que cessi la for\u00e7a a la qual est\u00e0 sotmesa la medul\u00b7la espinal i aquesta deixi d’enviar est\u00edmuls de flexi\u00f3 a la columna vertebral, aturant el proc\u00e9s de tracci\u00f3.<\/p>\n

 <\/p>\n

\n

Refer\u00e8ncies bibliogr\u00e0fiques<\/strong><\/h2>\n

 <\/p>\n

    \n
  1. Dr. Miguel B. Royo Salvador (1996), Platibasia<\/strong>, impresi\u00f3n basilar, retroceso odontoideo y kinking del tronco cerebral, etiolog\u00eda com\u00fan con la siringomielia<\/strong>, escoliosis<\/strong> y malformaci\u00f3n de Arnold-Chiari<\/strong> idiop\u00e1ticas (PDF).<\/a> REV NEUROL (Barc); 24 (134): 1241-1250<\/li>\n
  2. Dr. Miguel B. Royo Salvador (1997), Nuevo tratamiento quir\u00fargico para la siringomielia<\/strong>, la escoliosis<\/strong>, la malformaci\u00f3n de Arnold-Chiari<\/strong>, el kinking del tronco cerebral, el retroceso odontoideo, la impresi\u00f3n basilar y la platibasia idiop\u00e1ticas (PDF).<\/a> REV NEUROL; 25 (140): 523-530<\/li>\n
  3. M. B. Royo-Salvador (2014), “Filum System\u00ae<\/sup> Bibliography” (PDF).<\/a><\/li>\n
  4. M. B. Royo-Salvador (2014), “Filum System\u00ae<\/sup> Gu\u00eda Breve”.<\/a><\/li>\n<\/ol>\n","protected":false},"featured_media":1373,"template":"","class_list":["post-15062","enfermedades","type-enfermedades","status-publish","has-post-thumbnail","hentry"],"yoast_head":"\nPlatibasia, simptomes i diagn\u00f3stic | Institut Chiari Barcelona<\/title>\n<meta name=\"description\" content=\"La Platibasia consistent en l'aplanament de la base del crani, que es tradueix en l'obertura de l'angle basal de Boogard.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/institutchiaribcn.com\/ca\/platibasia\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Platibasia, simptomes i diagn\u00f3stic | Institut Chiari Barcelona\" \/>\n<meta property=\"og:description\" content=\"La Platibasia 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