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ADOLESCENT IDIOPATHIC SCOLIOSIS: PROGRESSION OF UNTREATED CASES 青少年特发性脊柱侧凸:未经治疗病例的进展
Q4 Medicine Pub Date : 2023-07-21 DOI: 10.1590/s1808-185120232202262590
J. S. E. L. Schleder, João Lucas dos Santos, M. Lima, Sylvio Mistro Neto, André Frazão Rosa, Wagner Pasqualini, M. Tebet, P. Cavali, Marcelo ítalo Risso Neto
ABSTRACT Objective: This study aims to evaluate angular progression of patients with a diagnosis of Adolescent Idiopathic Scoliosis (AIS), that await surgical treatment. Methods: This is an observational and descriptive study. Data were collected for age at initial surgical indication, initial date and Cobb angle, date and Cobb angle of the follow-up visit, time elapsed between the initial and follow-up visit, and type of curve. All recorded Cobb angles were reviewed by the authors. Results: 86.1% of the individuals were women, the mean age of indication for surgical treatment was 13.34 years. The most common type of curve was Lenke 3 and the one that progressed the most was Lenke 4. The general average of annual progression was 9.89 degrees for the primary curves and 12.32 for the secondary curves, and the follow-up was, on average, 35.77 months. Conclusion: The progression of the magnitude of the curve increases during the wait for the definitive treatment of AIS, no matter which group of the Lenke classification the curve belongs to. The secondary curves present a progression rate of 12.32º/year, higher than the main curve, which presents a rate of 9.89º/year. The waiting time has been increasing over the years, which is evident compared to older publications. Level of Evidence IV; Type of Study: Prognostic Study.
摘要目的:本研究旨在评估诊断为青少年特发性脊柱侧凸(AIS)并等待手术治疗的患者的角度进展。方法:这是一项观察性描述性研究。收集患者初始手术指征时的年龄、初始日期和Cobb角、随访日期和Cobb角、初始和随访时间、曲线类型等数据。所有记录的Cobb角均由作者审阅。结果:86.1%的患者为女性,平均适应手术年龄为13.34岁。最常见的曲线类型是Lenke 3型,最常见的曲线类型是Lenke 4型。主要弯曲的年平均进展为9.89度,次要弯曲的年平均进展为12.32度,随访时间平均为35.77个月。结论:无论该曲线属于Lenke分类的哪一组,在等待AIS明确治疗期间,该曲线的幅度均呈递增趋势。次级曲线的递进率为12.32º/年,高于主曲线的递进率9.89º/年。多年来,等待时间一直在增加,这与旧出版物相比是显而易见的。证据水平IV;研究类型:预后研究。
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引用次数: 0
ANESTHETIC BLOCK OF THE INTERTRANSVERSE SEPTUM, A PROSPECTIVE OBSERVATIONAL STUDY 横隔麻醉阻滞,一项前瞻性观察研究
Q4 Medicine Pub Date : 2023-07-21 DOI: 10.1590/s1808-185120232202273044
P. S. Meira, E. Vialle, W. Kisaki, A. Arruda, L. Vialle, J. Guasque, Luiz Gustavo Dal'Oglio da Rocha, Ubirajara Bley Filho
ABSTRACT Objective: To evaluate the influence of intertransverse septal anesthetic block (BASIT) on postoperative pain in lumbar spine surgery. Methods: The study was carried out prospectively and observationally. Were included 105 patients who underwent posterior lumbar spine surgery, divided into two groups: 35 patients in the experimental group, who received BASIT at the end of the procedure, and 70 patients in the control group, without BASIT. Patients were assessed for low back pain (visual pain scale), opioid consumption on the 1st postoperative day, complications related to the procedure, and length of stay after surgery. Results: The sample consisted of 46 men and 59 women, with a mean age of 57.7 years (21 to 90 years). Mean postoperative pain in the experimental group was 1.88, and in the control group 2.11 (p<0.05). There was a trend towards less morphine use in the experimental group with p = 0.053. There was a statistical difference in morphine consumption between patients who did not previously use opioids and those who already used them (p 0.04). There was no difference between the groups regarding length of stay. Conclusion: Anesthetic blockade of the intertransverse septum reduced the consumption of opioids and the levels of low back pain after surgery (p<0.05), with no statistical difference in length of hospital stay or complications related to the technique. Level of Evidence II; Clinical Prospective Study.
摘要目的:探讨横隔麻醉阻滞(BASIT)对腰椎手术术后疼痛的影响。方法:采用前瞻性观察方法。纳入105例后路腰椎手术患者,分为两组:实验组35例,在手术结束时接受BASIT治疗,对照组70例,不接受BASIT治疗。评估患者的腰痛(视觉疼痛量表)、术后第一天阿片类药物用量、手术相关并发症和术后住院时间。结果:本组患者男性46例,女性59例,平均年龄57.7岁(21 ~ 90岁)。实验组术后平均疼痛为1.88,对照组术后平均疼痛为2.11 (p<0.05)。实验组吗啡使用有减少的趋势(p = 0.053)。以前没有使用阿片类药物的患者和已经使用阿片类药物的患者在吗啡消耗方面存在统计学差异(p = 0.04)。两组之间在停留时间上没有差异。结论:横隔麻醉阻断可减少阿片类药物的使用和术后腰痛水平(p<0.05),住院时间和相关并发症无统计学差异。证据水平II;临床前瞻性研究。
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引用次数: 0
LUMBAR LORDOSIS VARIATION ACCORDING THE TYPE OF POSITIONER USED IN LUMBAR ARTHRODESIS 腰椎前凸的变化取决于腰椎关节融合术中使用的定位器类型
Q4 Medicine Pub Date : 2023-07-21 DOI: 10.1590/s1808-185120232202273127
Mateus Bergamo Lomaz, Pedro Felisbino Júnior, Sinval Dorneles Filho, Lucas Lodomiro Melo, Juliane leite Orcino, Murilo Ribeiro Sanches, Paolla Machado Cotrim, Gabriel João Francisco Souza, Thiago Vinicius de A. Morais, Paulo Henrique Martins Silva, M. Daher
ABSTRACT Objective: Evaluate the influence of the most used surgical positioners for lumbar lordosis (LL) in asymptomatic individuals. Methods: Cross-sectional study based on demographic data and radiographic parameters of asymptomatic individuals. For this study, 16 volunteers, 15 males, and one female were selected, and the average age was 24.6 years. They were submitted to lateral radiographs of the lumbar spine in orthostasis in use of the following positioners: gel cushion, gel cushion with hip extension, four-point Relton-Hall and Wilson-type positioner. Results: The mean LL in the orthostatic position was 58.76º, whereas in the gel cushion positioner it was 52.51; on the gel cushion with hip extension of 58.23º, Relton-Hall/4points 37.63º and, finally, on the Wilson-type positioner of 40.87º. An average reduction of 5.42º of the LL was observed when positioning on the gel cushion in relation to the orthostasis. In the linear regression analysis, the data presented statistically significant results (p<0.05), demonstrating that the L4-S1 segment influences 60% in LL. Conclusion: The positioner with gel cushion and hip extension reproduces an LL similar to physiological values. Relton-Hall and Wilson-type positioners with hip flexion promote hypolordotic positioning compared to basal lordosis in orthostasis. Hip extension alone generated a 5.96º increase in the subject’s lordosis. The L4-S1 segment has a 60% influence on the LL when the individuals are in the positioners. Level of evidence III; Controlled cross-sectional study.
摘要目的:评价无症状腰椎前凸(LL)患者最常用的手术定位器的影响。方法:基于人口统计学资料和无症状个体放射学参数的横断面研究。本次研究共选取16名志愿者,其中男性15名,女性1名,平均年龄24.6岁。他们在使用以下定位器时进行腰椎侧位片:凝胶垫,带髋关节伸展的凝胶垫,四点Relton-Hall和wilson型定位器。结果:直立体位的平均LL为58.76º,凝胶垫体位的平均LL为52.51º;凝胶垫的髋伸度为58.23º,Relton-Hall/4points为37.63º,wilson式定位器为40.87º。相对于直立器,在凝胶垫上定位时,观察到LL平均减少5.42º。在线性回归分析中,数据有统计学意义(p<0.05),表明L4-S1节段对LL的影响为60%。结论:带凝胶垫和髋关节伸展的定位器再现了与生理值相似的LL。与站立时的基础前凸相比,髋屈曲的Relton-Hall和wilson型定位器可促进脊柱下凸定位。仅髋部伸展可使受试者前凸增加5.96º。当个体处于位置时,L4-S1节段对LL的影响为60%。证据等级III;对照横断面研究。
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引用次数: 0
PYOGENIC SPONDYLODISCITIS: RISK FACTORS FOR THERAPEUTIC FAILURE AND RECURRENCE 化脓性脊柱炎:治疗失败和复发的危险因素
Q4 Medicine Pub Date : 2023-07-21 DOI: 10.1590/s1808-185120232202268880
Guilherme José da Nóbrega Danda, C. Castro
ABSTRACT Objective: Evaluate the prognostic factors associated with therapeutic failure and recurrence in pyogenic spondylodiscitis (PS). Methods: A historical cohort study was conducted in a reference Brazilian hospital for locomotor system and neurodevelopmental diseases. All patients with PS treated between January 1999 and December 2018 and followed for at least one year were included. PS was defined based on clinical, laboratory, and radiological criteria. Microbiological data and clinical outcomes at the end of follow-up were also collected and analyzed. Results: Fifty patients (mean age 50.94 ± 15.84 years, men 76.00%) were included. After twelve months of follow-up, therapeutic failure was observed in 24.00% (n = 12) and recurrence in 18.00% (n = 09) patients. Among those who were cured, residual symptoms were found in 50.00% (19/38). No deaths were observed. After multivariate analysis, therapeutic failure was associated with the prescription of antibiotic therapy before culture results (p = 0.0153), spinal cord compression (p = 0.0053), and sensory deficits (p = 0.0341). Furthermore, recurrence was associated with previous nonspinal surgeries (p = 0.0350) and spinal cord compression (p = 0.0447). Conclusion: PS causes significant morbidity. The prognosis depends mainly on the clinical presentation at admission, especially when associated with spinal cord compression, which reinforces the importance of early diagnosis. Level of Evidence II; Prognostic Studies.
摘要目的:评价化脓性脊椎炎(PS)治疗失败和复发的预后因素。方法:在巴西一家参考医院进行运动系统和神经发育疾病的历史队列研究。纳入1999年1月至2018年12月期间接受治疗并随访至少一年的所有PS患者。PS的定义基于临床、实验室和放射学标准。并收集和分析随访结束时的微生物学数据和临床结果。结果:纳入50例患者,平均年龄50.94±15.84岁,男性76.00%。随访12个月后,24.00% (n = 12)患者治疗失败,18.00% (n = 09)患者复发。痊愈者中残留症状占50.00%(19/38)。没有观察到死亡。多因素分析后,治疗失败与培养结果前的抗生素治疗处方(p = 0.0153)、脊髓压迫(p = 0.0053)和感觉缺陷(p = 0.0341)相关。此外,复发与既往非脊柱手术(p = 0.0350)和脊髓压迫(p = 0.0447)有关。结论:PS有明显的发病率。预后主要取决于入院时的临床表现,特别是与脊髓受压有关,这加强了早期诊断的重要性。证据水平II;预后研究。
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引用次数: 0
FUNCTIONALITY OF INDIVIDUALS WITH LOW BACK PAIN: CROSS-SECTIONAL STUDY WITH ICF CORE SET 腰痛患者的功能:icf核心组的横断面研究
Q4 Medicine Pub Date : 2023-07-21 DOI: 10.1590/s1808-185120232202265412
Renata Carolina Hort Brighenti, Bruna Camilla Gallon, Odonis Rocha Júnior, A. R. Fréz, C. Daniel, J. A. Ruaro, M. Baroni
ABSTRACT Objective: Characterize the functionality and disability of individuals complaining of low back pain at a physiotherapy service. Method: The study included individuals who complained of low back pain, treated at a physical therapy school clinic, over the age of 18. An online questionnaire was applied, with sociodemographic questions and questions corresponding to the codes of the brief “International Classification of Functioning, Disability, and Health” (ICF) for low back pain. Results: The total sample was 47 individuals, with an average of 65.31 ± 3.8 years, the majority were women (n = 40; 85.1%). The categories: pain functions (b280) and functions related to joint mobility (b710) had a higher prevalence of reports of severe to complete disabilities (89.5% and 55.3%, respectively). The other categories, in general, had a higher prevalence of mild to moderate dysfunction, with a greater report of dysfunction for the categories energy and impulse functions (b130), sleep functions (b134), emotional functions (b152), (76.6%, 66%, 76.6% respectively). Conclusion: The ICF core set for low back pain can be used electronically and allows you to evaluate and observe the various factors that are related to pain, enabling reflection and directing multidisciplinary interventions for the treatment of low back pain. Level of evidence III; Study of nonconsecutive patients; without consistently applied reference “gold” standard.
目的:描述在物理治疗服务中抱怨腰痛的个体的功能和残疾。方法:该研究包括在物理治疗学校诊所治疗的18岁以上的抱怨腰痛的个体。采用了一份在线调查问卷,其中包括社会人口学问题和与腰痛简短的“国际功能、残疾和健康分类”(ICF)代码相对应的问题。结果:共47例,平均年龄65.31±3.8岁,以女性居多(n = 40;85.1%)。疼痛功能(b280)和关节活动相关功能(b710)报告的严重至完全残疾发生率较高(分别为89.5%和55.3%)。总的来说,其他类别有较高的轻度至中度功能障碍患病率,其中能量和冲动功能(b130)、睡眠功能(b134)、情绪功能(b152)类别的功能障碍报告较多(分别为76.6%、66%和76.6%)。结论:针对腰痛的ICF核心集可以电子使用,并允许您评估和观察与疼痛相关的各种因素,从而能够反思和指导腰痛治疗的多学科干预。证据等级III;非连续患者研究;没有一贯适用的参考“黄金”标准。
{"title":"FUNCTIONALITY OF INDIVIDUALS WITH LOW BACK PAIN: CROSS-SECTIONAL STUDY WITH ICF CORE SET","authors":"Renata Carolina Hort Brighenti, Bruna Camilla Gallon, Odonis Rocha Júnior, A. R. Fréz, C. Daniel, J. A. Ruaro, M. Baroni","doi":"10.1590/s1808-185120232202265412","DOIUrl":"https://doi.org/10.1590/s1808-185120232202265412","url":null,"abstract":"ABSTRACT Objective: Characterize the functionality and disability of individuals complaining of low back pain at a physiotherapy service. Method: The study included individuals who complained of low back pain, treated at a physical therapy school clinic, over the age of 18. An online questionnaire was applied, with sociodemographic questions and questions corresponding to the codes of the brief “International Classification of Functioning, Disability, and Health” (ICF) for low back pain. Results: The total sample was 47 individuals, with an average of 65.31 ± 3.8 years, the majority were women (n = 40; 85.1%). The categories: pain functions (b280) and functions related to joint mobility (b710) had a higher prevalence of reports of severe to complete disabilities (89.5% and 55.3%, respectively). The other categories, in general, had a higher prevalence of mild to moderate dysfunction, with a greater report of dysfunction for the categories energy and impulse functions (b130), sleep functions (b134), emotional functions (b152), (76.6%, 66%, 76.6% respectively). Conclusion: The ICF core set for low back pain can be used electronically and allows you to evaluate and observe the various factors that are related to pain, enabling reflection and directing multidisciplinary interventions for the treatment of low back pain. Level of evidence III; Study of nonconsecutive patients; without consistently applied reference “gold” standard.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67481341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
EPIDEMIOLOGICAL PATTERNS OF ADOLESCENT IDIOPATHIC SCOLIOSIS IN A SPINAL CENTER IN CURITIBA 库里蒂巴脊柱中心青少年特发性脊柱侧凸的流行病学模式
Q4 Medicine Pub Date : 2023-07-21 DOI: 10.1590/s1808-185120232202273533
E. Vialle, A. Arruda, J. Guasque, Bárbara Miroski de Oliveira Pinto, Gabriel Trentini Beraldo
ABSTRACT Objective: Evaluation of the profile of the population with adolescent idiopathic scoliosis (AIS) treated at a center specializing in spine surgery in Curitiba-PR. Methods: Prospective multicenter study, being analyzed, at the moment, only data from the center in question. All patients referred from the basic health service for evaluation of deformity underwent panoramic radiography of the total spine to evaluate the curvature using the Cobb method, evaluation of skeletal maturity using the Risser classification, and the classification of scoliosis using the Lenke classification. Clinical photographs of all patients and an assessment of the quality of life using the SRS-30 questionnaire were also taken. Results: Thirty patients with scoliosis and a mean age of 14.63 ± 3 years were evaluated. Prevalence of female:male 1.5:1. Patients had a mean Cobb of 45.96°, and most were close to Risser 4 skeletal maturity (48.3%). 60% had a thoracic curve (Lenke 1), and 13.3% had a double curve (Lenke 3 or 6). 63.3% of cases had a delay in medical care, taking an average of 18 months between referral and consultation with a specialist. 60% of patients were referred for surgical treatment after the first appointment. Conclusion: The population sample of this center follows the literature. A Cobb >40° in the first consultation with a specialist and a high referral rate to surgery suggest the failure of early diagnosis and the need for public policies for better knowledge and assistance for adolescent idiopathic scoliosis. Level of Evidence IV; Descriptive Epidemiological Study.
【摘要】目的:评估库里蒂巴- pr一家脊柱外科中心治疗的青少年特发性脊柱侧凸(AIS)患者的概况。方法:前瞻性多中心研究,目前仅分析该中心的数据。所有从基本卫生服务中心转来评估畸形的患者都接受了全脊柱全景x线摄影,使用Cobb法评估脊柱曲度,使用Risser分类评估骨骼成熟度,使用Lenke分类评估脊柱侧凸。所有患者的临床照片和使用SRS-30问卷的生活质量评估也被采取。结果:30例脊柱侧凸患者,平均年龄14.63±3岁。女性患病率:男性1.5:1。患者平均Cobb为45.96°,大多数患者骨骼成熟度接近Risser 4(48.3%)。60%的患者有胸弯(Lenke 1), 13.3%的患者有双弯(Lenke 3或6)。63.3%的患者延迟就医,从转诊到专科就诊平均耗时18个月。60%的患者在第一次预约后转介手术治疗。结论:本中心人口样本符合文献。首次咨询专家时的Cobb bb 40°和高手术转诊率表明早期诊断失败,需要公共政策来更好地了解和帮助青少年特发性脊柱侧凸。证据水平IV;描述性流行病学研究。
{"title":"EPIDEMIOLOGICAL PATTERNS OF ADOLESCENT IDIOPATHIC SCOLIOSIS IN A SPINAL CENTER IN CURITIBA","authors":"E. Vialle, A. Arruda, J. Guasque, Bárbara Miroski de Oliveira Pinto, Gabriel Trentini Beraldo","doi":"10.1590/s1808-185120232202273533","DOIUrl":"https://doi.org/10.1590/s1808-185120232202273533","url":null,"abstract":"ABSTRACT Objective: Evaluation of the profile of the population with adolescent idiopathic scoliosis (AIS) treated at a center specializing in spine surgery in Curitiba-PR. Methods: Prospective multicenter study, being analyzed, at the moment, only data from the center in question. All patients referred from the basic health service for evaluation of deformity underwent panoramic radiography of the total spine to evaluate the curvature using the Cobb method, evaluation of skeletal maturity using the Risser classification, and the classification of scoliosis using the Lenke classification. Clinical photographs of all patients and an assessment of the quality of life using the SRS-30 questionnaire were also taken. Results: Thirty patients with scoliosis and a mean age of 14.63 ± 3 years were evaluated. Prevalence of female:male 1.5:1. Patients had a mean Cobb of 45.96°, and most were close to Risser 4 skeletal maturity (48.3%). 60% had a thoracic curve (Lenke 1), and 13.3% had a double curve (Lenke 3 or 6). 63.3% of cases had a delay in medical care, taking an average of 18 months between referral and consultation with a specialist. 60% of patients were referred for surgical treatment after the first appointment. Conclusion: The population sample of this center follows the literature. A Cobb >40° in the first consultation with a specialist and a high referral rate to surgery suggest the failure of early diagnosis and the need for public policies for better knowledge and assistance for adolescent idiopathic scoliosis. Level of Evidence IV; Descriptive Epidemiological Study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67481830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CLINICAL PHOTOGRAPHIC AND RADIOLOGICAL CORRELATION IN PATIENTS WITH SCOLIOSIS 脊柱侧凸患者的临床摄影和放射学相关性
Q4 Medicine Pub Date : 2023-07-21 DOI: 10.1590/s1808-185120232202273438
Thales Henrique Garcia Gonçalves, H. Defino
ABSTRACT Objective: The study correlates angular radiographic measurements and measurements from photographs of the trunk of patients with adolescent idiopathic scoliosis. Methods: a cross-sectional study of 10 patients with adolescent idiopathic scoliosis and indication for surgical treatment in follow-up in the spine sector of HCRFMRP-USP. They were evaluated through measurements taken from clinical photographs of the patient’s torso and angles on panoramic radiographs of the spine. Results: only the correlation between the axilla angle (AHA) and the proximal thoracic curve and main thoracic curve was observed in the sample studied. No correlation was observed between the other compared variables. The study was carried out in a sample with a small number of patients, whose objective was to carry out a pilot study to explore this topic. Conclusion: the analysis of deformities should consider the aesthetic aspect and radiographic evaluation; however, in this study, no statistical correlation was observed between these parameters. Level of Evidence IV; Case Series Study.
摘要:目的:研究青少年特发性脊柱侧凸患者的x线角度测量和躯干照片测量的相关性。方法:对10例青少年特发性脊柱侧凸患者进行横断面研究,并对HCRFMRP-USP脊柱部分的手术指征进行随访。通过对患者躯干的临床照片和脊柱全景x线片的角度进行测量来评估。结果:在研究的样本中,仅观察到腋窝角(AHA)与胸近端曲线和胸主曲线的相关性。其他比较变量之间无相关性。本研究是在少数患者的样本中进行的,其目的是开展一项初步研究来探索这一主题。结论:畸形的分析应考虑美学方面和影像学评价;然而,在本研究中,这些参数之间没有统计学相关性。证据水平IV;案例系列研究。
{"title":"CLINICAL PHOTOGRAPHIC AND RADIOLOGICAL CORRELATION IN PATIENTS WITH SCOLIOSIS","authors":"Thales Henrique Garcia Gonçalves, H. Defino","doi":"10.1590/s1808-185120232202273438","DOIUrl":"https://doi.org/10.1590/s1808-185120232202273438","url":null,"abstract":"ABSTRACT Objective: The study correlates angular radiographic measurements and measurements from photographs of the trunk of patients with adolescent idiopathic scoliosis. Methods: a cross-sectional study of 10 patients with adolescent idiopathic scoliosis and indication for surgical treatment in follow-up in the spine sector of HCRFMRP-USP. They were evaluated through measurements taken from clinical photographs of the patient’s torso and angles on panoramic radiographs of the spine. Results: only the correlation between the axilla angle (AHA) and the proximal thoracic curve and main thoracic curve was observed in the sample studied. No correlation was observed between the other compared variables. The study was carried out in a sample with a small number of patients, whose objective was to carry out a pilot study to explore this topic. Conclusion: the analysis of deformities should consider the aesthetic aspect and radiographic evaluation; however, in this study, no statistical correlation was observed between these parameters. Level of Evidence IV; Case Series Study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67481689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
THE LAMARTINA SQUARE AND SEVERITY INDEX IN SURGERY FOR HIGH-GRADE LUMBAR LISTHESIS 高度腰椎脱位手术中的拉玛蒂纳方和严重程度指数
Q4 Medicine Pub Date : 2023-06-23 DOI: 10.1590/s1808-185120222202272598
J. A. A. Oliveira, V. T. G. Silva, Antônio Eulálio Pedrosa Araújo Junior, Luis Antonio Medeiros Moliterno, P. C. Almeida, L. Silva, R. Meireles
ABSTRACT Objective: evaluate the correlation between main sacropelvic alignment measurements and pelvic retroversion reduction and assessing Lamartina Square effectiveness in choosing the proximal instrumentation level. Methods: sample comprising 21 patients with high-grade L5 -S1 spondylolisthesis subjected to arthrodesis with instrumentation from January 2004 to December 2016. Patients’ demographic data, surgery type, complications, sagittal alignment parameters, Severity Index and Lamartina Square were recorded before surgery and in the last follow-up. Data processed in SPSS 22.0, with different means were calculated through Student’s t test, for paired data. Linear correlation analysis was performed based on Spearman’s coefficient. P <0.05 was statically significant. Results: there was significant improvement in the slip and Dubousset’s lumbosacral kyphosis angles (> 100° in the last postoperative follow-up). There was significant reduction of slip rate ( and in the L4 and L5 Severity Index, which highlighted strong correlation to pelvic tilt, mismatch and slip angle. Severity index also showed strong inverse correlation between Dubousset’s lumbosacral kyphosis angle and sacral slope. Conclusion: L5 Severity Index and Lamartina Square are important variables for preoperative planning of patients with high-grade lumbar spondylolisthesis. Level of Evidence IV; Case Series.
目的:评价骶盆腔主位测量与骨盆后倾复位的相关性,评估拉玛蒂娜方在选择近端内固定水平时的有效性。方法:2004年1月至2016年12月,21例高度L5 -S1椎体滑脱患者行固定术。记录患者术前及末次随访时的人口学资料、手术类型、并发症、矢状面排列参数、严重程度指数和拉马蒂娜广场。配对数据采用SPSS 22.0软件处理,采用不同方法,采用Student’s t检验。根据Spearman系数进行线性相关分析。术后最后一次随访p100°)。滑移率(以及L4和L5严重指数)显著降低,这突出了与骨盆倾斜、失配和滑移角的强相关性。Dubousset腰骶后凸角与骶骨坡度呈显著负相关。结论:L5严重指数和Lamartina Square是高度腰椎滑脱患者术前规划的重要变量。证据水平IV;病例系列。
{"title":"THE LAMARTINA SQUARE AND SEVERITY INDEX IN SURGERY FOR HIGH-GRADE LUMBAR LISTHESIS","authors":"J. A. A. Oliveira, V. T. G. Silva, Antônio Eulálio Pedrosa Araújo Junior, Luis Antonio Medeiros Moliterno, P. C. Almeida, L. Silva, R. Meireles","doi":"10.1590/s1808-185120222202272598","DOIUrl":"https://doi.org/10.1590/s1808-185120222202272598","url":null,"abstract":"ABSTRACT Objective: evaluate the correlation between main sacropelvic alignment measurements and pelvic retroversion reduction and assessing Lamartina Square effectiveness in choosing the proximal instrumentation level. Methods: sample comprising 21 patients with high-grade L5 -S1 spondylolisthesis subjected to arthrodesis with instrumentation from January 2004 to December 2016. Patients’ demographic data, surgery type, complications, sagittal alignment parameters, Severity Index and Lamartina Square were recorded before surgery and in the last follow-up. Data processed in SPSS 22.0, with different means were calculated through Student’s t test, for paired data. Linear correlation analysis was performed based on Spearman’s coefficient. P <0.05 was statically significant. Results: there was significant improvement in the slip and Dubousset’s lumbosacral kyphosis angles (> 100° in the last postoperative follow-up). There was significant reduction of slip rate ( and in the L4 and L5 Severity Index, which highlighted strong correlation to pelvic tilt, mismatch and slip angle. Severity index also showed strong inverse correlation between Dubousset’s lumbosacral kyphosis angle and sacral slope. Conclusion: L5 Severity Index and Lamartina Square are important variables for preoperative planning of patients with high-grade lumbar spondylolisthesis. Level of Evidence IV; Case Series.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67481135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
SPINAL FRACTURES AND THORACOABDOMINAL INJURIES IN POLYTRAUMATIZED PATIENTS: EPIDEMIOLOGICAL EVALUATION 多发创伤患者脊柱骨折和胸腹损伤:流行病学评价
Q4 Medicine Pub Date : 2023-06-23 DOI: 10.1590/s1808-185120222202267378
Alan Antonelli, Álynson Larocca Kulcheski, André Luís Sebben, F. Nanni, Pedro Grein del Santoro, M. L. Benato, X. S. Graells
ABSTRACT Objective: Establish the frequency of incidences, management, and description of the relationship between thoracic and abdominal trauma and spinal injury. Methods: Observational, retrospective study of quantitative analysis carried out through the analysis of medical records of patients who presented spinal fractures and associated thoracoabdominal injuries. The participants were treated at a reference hospital in trauma care in Curitiba-PR from 2019 to 2021. The data were from patients with spine fractures referring to gender, age, trauma mechanism, fracture classification, associated injuries, Frankel neurological scale, and proposed treatment. Results: There was a predominance of male patients (84.5%) and young, with a mean age of 37.3 years, victims of car accidents. The main vertebrae affected were the lumbar spine (36.8%) and thoracic spine (36.2%). The most prevalent associated injuries were extra vertebral and cervical spine fractures. The most observed thoracic injuries were hemothorax, chest contusion, and fracture of multiple costal arches, while the most observed abdominal injuries were kidney injury, hemoperitoneum/abdominal hematoma, and liver injury. Of the total patients analyzed, 68% had fractures with associated thoracoabdominal injuries. Conclusion: Abdominal and thoracic injuries are frequently associated with spine fractures, with an association of 14.6% and 53.4%, respectively. The production of knowledge on the subject contributes to creating action plans to optimize the management and reduce the morbidity and mortality of these cases. Levels of evidence III; Systematic Review.
【摘要】目的:探讨胸腹外伤与脊柱损伤的发生率、处理及关系。方法:通过对脊柱骨折合并胸腹损伤患者病历的分析,采用观察性、回顾性的定量分析方法。参与者于2019年至2021年在库里蒂巴- pr的一家创伤护理参考医院接受治疗。数据来自脊柱骨折患者,包括性别、年龄、创伤机制、骨折分类、相关损伤、Frankel神经学量表和建议的治疗方法。结果:以男性为主(84.5%),以年轻为主,平均年龄37.3岁。主要椎体为腰椎(36.8%)和胸椎(36.2%)。最常见的相关损伤是椎体外骨折和颈椎骨折。胸部损伤以血胸、胸挫伤、多肋弓骨折为主,腹部损伤以肾损伤、腹膜/腹部血肿、肝损伤为主。在分析的所有患者中,68%的患者骨折并伴有胸腹损伤。结论:腹部和胸部损伤常与脊柱骨折相关,相关性分别为14.6%和53.4%。这方面知识的产生有助于制定行动计划,以优化管理并降低这些病例的发病率和死亡率。证据等级III;系统的回顾。
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引用次数: 0
ANALYSIS OF CERVICAL SAGITTAL BALANCE IN PATIENTS NECK PAIN AND NO NECK PAIN 颈痛与无颈痛患者颈椎矢状平衡分析
Q4 Medicine Pub Date : 2023-06-23 DOI: 10.1590/s1808-185120222202265303
Vania Maria Lima, M. Reis, Nilson Mozas Olivares, Guilherme Reiff Toller, Daniel Jose Mazzo Bedran de Castro, Orlando Rafael de Andrade Madrid
ABSTRACT Introduction: Sagittal balance was measured by Hardacker`s et al. using the occipital method COBB C1-C2, C2-C3, C3-C4, C4-C5, C5-C6, C6-C7 in a sample of asymptomatic patients without neck and shoulder pain. In other recent studies, measurements of cervical sagittal balance included several radiographic parameters. Objective: To compare the cervical sagittal balance in groups of patients with and without neck pain submitted to cervical radiography with the upper limbs in flexion. Methods: This is a cross-sectional, quantitative, prospective, descriptive study with radiographic analysis of 50 adults aged between 30 to 70 years old. The group was divided into Group 1: without neck pain, and Group 2: with neck pain. All answered a questionnaire about age and the presence or absence of neck pain. Exclusion criteria were: inadequate X-Ray image, deformity or previous spine surgery, limited shoulder mobility, and individuals younger than 30 and older than 70. The radiographic parameters evaluated were: COBB, TIA ( THORACIC INLET ANGLE), T1 SLOPE, NECKTILT, and COG-C7 with no neck pain. α = 5% (significance when p <0.05). Results: The MANN WHITNEY nonparametric test showed no significant differences between Cobb GROUPS (p= 0.7452), T1 SLOPE GROUPS (p=0.1410), NECKTILT GROUPS (p=0.0852) and GROUPS THORACIC INLET ANGLE (p=0.1789). Conclusion: There was a significant difference only between COG-C7 GROUPS (cm) (p=0.0013). The analysis of the obtained data showed statistical significance in the variation in the COG-C7 groups. Level of Evidence II; Prospective comparative study.
摘要:Hardacker等人在无颈肩痛的无症状患者中采用枕部法COBB C1-C2、C2-C3、C3-C4、C4-C5、C5-C6、C6-C7测量矢状位平衡。在最近的其他研究中,测量颈椎矢状面平衡包括几个放射学参数。目的:比较上肢屈曲颈椎x线摄影中有无颈部疼痛患者的颈椎矢状平衡情况。方法:这是一项横断面、定量、前瞻性、描述性研究,对50名年龄在30至70岁之间的成年人进行影像学分析。将患者分为无颈部疼痛组1和有颈部疼痛组2。所有人都回答了一份关于年龄和有无颈部疼痛的问卷。排除标准为:x线影像不全,畸形或既往脊柱手术,肩部活动受限,年龄小于30岁,年龄大于70岁。影像学参数评估为:COBB、TIA(胸入口角)、T1 SLOPE、NECKTILT和COG-C7,无颈部疼痛。α = 5% (p <0.05时具有显著性)。结果:MANN WHITNEY非参数检验显示Cobb组(p= 0.7452)、T1 SLOPE组(p=0.1410)、NECKTILT组(p=0.0852)和胸入口角组(p=0.1789)之间无显著差异。结论:仅COG-C7组间差异有统计学意义(p=0.0013)。对所得数据进行分析,COG-C7组间差异有统计学意义。证据水平II;前瞻性比较研究。
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