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EPIDEMIOLOGICAL PROFILE IN A TERTIARY ADMISSION UNIT OF SPINE DISEASES 脊柱疾病三级住院单位的流行病学概况
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203272944
BRIAN GUILHERME MONTEIRO MARTA COIMBRA, MATHEUS TRINDADE BRUXELAS DE FREITAS, RAFAELA PEREIRA DE LIMA, DANIEL DUARTE PERINI, TARCíSIO ELOY PESSOA DE BARROS FILHO, ALEXANDRE FOGAçA CRISTANTE, RAPHAEL MARTUS MARCON
ABSTRACT Introduction: In March 2020, WHO officially decreed that the world was going through a pandemic, that of Covid-19. In May 2022, in Brazil, the end of measures to deal with the pandemic was decreed. In 2022, there was a movement to return to normal care in the provision of care. Objective: In the present study, we carried out a retrospective descriptive analysis of the epidemiological scenario of the ward of the Spine Group at the Hospital das Clínicas of the Faculty of Medicine of the Universidade de São Paulo (HC-FMUSP). Method: Data analysis was performed from information gathered in patients’ medical records. Results: In the analyzed period, there were 152 consultations in hospitalization, with the main cause being spinal trauma. Of all the cases, only 23.68% were scheduled on an elective basis, which despite being a lower than expected number, was shaped by the demands of urgent care channeled to the service in question. Conclusion: Despite a higher number of cases hospitalized in the post-pandemic period, there is still the expectancy of more elective cases to be treated in the future. Level of Evidence III; Retrospective Case Series Study.
摘要:2020年3月,世卫组织正式宣布世界正在经历一场大流行,即Covid-19。2022年5月,在巴西,应对大流行的措施结束了。2022年,在提供护理方面出现了恢复正常护理的运动。目的:在本研究中,我们对圣保罗大学医学院(HC-FMUSP) das医院(Clínicas)脊柱组病房的流行病学情况进行了回顾性描述性分析。方法:对收集到的患者病历资料进行数据分析。结果:分析期内住院会诊152例,以脊柱外伤为主。在所有病例中,只有23.68%是在选择性基础上安排的,尽管这一数字低于预期,但这是由于向有关服务提供紧急护理的需求造成的。结论:尽管大流行后住院的病例数量较高,但预计未来仍有更多的选择性病例需要治疗。证据等级III;回顾性病例系列研究。
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引用次数: 0
PREVALENCE OF SPINAL DISEASES IN PRACTITIONERS OF BODYBUILDING 健身从业人员脊柱疾病的患病率
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203273480
NATAN WILD, CAROLINE ANDREAZZA
ABSTRACT Introduction: Low back pain has a high prevalence, impacting the quality of life. Bodybuilding has been studied as a conservative treatment that helps reduce pain, but it is still underused and often associated with worsening the pathology. Objective: The objective of the study is to describe the prevalence of spinal diseases in bodybuilders and observe the degree of perceived improvement with the practice of the same. Methods: A cross-sectional study was carried out in a gym in the interior of Rio Grande do Sul. The sample considered 40 participants of both genders and was randomly chosen. Bodybuilding practitioners were included for more than six months and those over 18 years of age. A sociodemographic and clinical experiment was used to analyze the individual characteristics of the participants, and an analog pain scale (VAS) was used to compare pain before and after bodybuilding. Results: Of the study participants, 62.5% had no spinal pathologies against 37.5% (p-value = 0.025). The main pathology was low back pain in 40.0% of the cases, but that is not statistically different from the 33.3% with scoliosis/kyphosis/lordosis (p-value = 0.705), nor the 13.3% with disc herniation (p-value = 0.099). In the general analysis of the VAS, the score given for pain before bodybuilding was 5.73, and after 2.27 (p-value = 0.001). Conclusion: The practice of bodybuilding, when appropriate, is a tool that can help improve referred pain in patients with spinal pathology. Level of Evidence III; Retrospective comparative studye.
摘要简介:腰痛发病率高,影响生活质量。健身被认为是一种有助于减轻疼痛的保守治疗方法,但它仍然没有得到充分利用,而且往往与恶化的病理有关。目的:本研究的目的是描述健美运动员脊柱疾病的患病率,并观察他们的知觉改善程度。方法:横断面研究在南里奥格兰德州的一个健身房进行。该样本包括40名男女参与者,是随机选择的。研究对象包括健身时间超过6个月的人以及18岁以上的人。采用社会人口学和临床实验分析参与者的个体特征,并采用模拟疼痛量表(VAS)比较健身前后的疼痛。结果:62.5%的研究参与者没有脊柱病变,而37.5% (p值= 0.025)。40.0%的病例以腰痛为主要病理,但与脊柱侧凸/后凸/前凸的33.3% (p值= 0.705)和椎间盘突出的13.3% (p值= 0.099)无统计学差异。在VAS综合分析中,运动前疼痛评分为5.73分,运动后疼痛评分为2.27分(p值= 0.001)。结论:在适当的情况下,健身是一种可以帮助改善脊柱病变患者牵涉性疼痛的工具。证据等级III;回顾性比较研究。
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引用次数: 0
THORACIC-LUMBAR ARTHRODESIS VIA EXTREME LATERAL APPROACH: A RETROSPECTIVE STUDY 极外侧入路胸腰椎关节融合术:一项回顾性研究
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203250452
FELIPI FERREIRA LAZZARI, ÁLYNSON LAROCCA KULCHESKI, ANDRé LUIS SEBBEN, PEDRO GREIN DEL SANTORO, MARCEL LUIZ BENATO, MARIA EDUARDA PEREIRA CARGNIN, XAVIER SOLER GRAELLS
ABSTRACT Objective: To evaluate the epidemiological, clinical, and radiological data of patients treated with XLIF, including the impact on quality of life, pain parameters, and improvement of lumbar lordosis. Methods: Retrospective longitudinal study, in which medical records of patients who underwent XLIF between 2017 and 2020 at Hospital do Trabalhador/UFPR were reviewed. Demographic characteristics and radiological aspects, such as the Cobb angle, were recorded. Clinical characteristics using parameters such as pain by VAS and the disability index by ODI were evaluated before surgery and 12 months after. Results: Female patients predominated (66.7%), with a mean age of 59.1 years (35-82 years). The length of stay, in the median, was three days, and the time to return to daily activities was three months. Only four patients (8.9%) had complications. The questionnaire analysis showed a significant difference between all scales’ pre and postoperative scores. The ODI showed an average reduction of 39.2%, and the median score of VAS in the postoperative period was half the preoperative period (reduction of 50%; p <0.001). The lordosis angle increased by 26.3% in the postoperative period (p <0.001). Conclusion: XLIF presents low complication rates, improves lumbar lordosis, and allows recovery from daily activities in a short period, in addition to performing a statistically significant improvement in quality of life and pain according to the VAS and ODI scales, being, therefore, a viable and effective treatment technique. Level of Evidence II; Retrospective Study.
目的:评价XLIF治疗患者的流行病学、临床和影像学资料,包括对生活质量、疼痛参数和腰椎前凸改善的影响。方法:回顾性纵向研究,回顾2017 - 2020年在Trabalhador/UFPR医院行XLIF患者的病历。记录了人口统计学特征和放射学方面,如Cobb角。术前和术后12个月分别用VAS评估疼痛和ODI评估残疾指数等参数评价临床特征。结果:女性患者居多(66.7%),平均年龄59.1岁(35 ~ 82岁)。住院时间中位数为3天,恢复日常活动的时间为3个月。仅有4例(8.9%)出现并发症。问卷分析显示,各量表术前、术后评分差异有统计学意义。ODI平均下降39.2%,术后VAS中位评分为术前的一半(下降50%;p & lt; 0.001)。术后前凸角增加26.3% (p <0.001)。结论:XLIF并发症发生率低,改善腰椎前凸,可在短时间内恢复日常活动,并根据VAS和ODI量表对生活质量和疼痛有统计学意义的改善,因此是一种可行有效的治疗技术。证据水平II;回顾性研究。
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引用次数: 0
STUDY ON PEDIATRIC SCOLIOSIS PATIENTS AT HOSPITAL SANTA CASA DE MISERICÓRDIA IN SÃO PAULO 圣保罗misericÓrdia Santa casa医院小儿脊柱侧凸患者的研究
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203273284
FELIPE NEVES SIMõES MONTEIRO, MURILO ALEXANDRE, WILLIAM ZARZA SANTOS, RODRIGO GóES MEDEA DE MENDONÇA, ALBERTO OFENHEJM GOTFRYD, MARIA FERNANDA SILBER CAFFARO, ROBERT MEVES
ABSTRACT Objective: To carry out registration of patients with scoliosis under 18 years old, followed in a quarternary hospital of high complexity, who need surgical treatment, aiming to identify the reasons for the delay in treatment. Methods: Data collection was carried out in person and by spontaneous demand at the spinal orthopedic specialty outpatient clinic in a tertiary hospital of high complexity from January 2021 to December 2022. The results were compiled in the networked database (Red Cap®). Result: 59 patients were evaluated, 45 female (77.9%) and 14 male (22.1%), with a mean age of 13.7 years. Etiology: 30 idiopathic (50.8%), eight syndromic (13.5%), 11 neuromuscular (18.6%), and ten congenital (16.9%). Of the total, 46 (77.9%) were awaiting surgery and 13 (22.1%) were undergoing conservative treatment. The main causes of treatment delay: unavailability of intraoperative neurophysiological monitoring (19 - 41.3%); unavailability of specific surgical material (16 - 34.8%); difficulty of referral to our institution (6 - 13.1%); loss to follow-up (3 - 6.5%) and limitation in casting making (2 - 4.3%). The mean time between diagnosis and the first consultation is 17.25 months (0 - 140). The average surgical wait until December/2022 was 38.4 months (1 - 156). Conclusion: There is a lack of assistance in the steps of monitoring and treatment in the public health system, from directing the patient with scoliosis to the specialized center to performing the surgical procedure, mainly due to limitations in the use of intraoperative neurophysiological monitoring and the unavailability of specific materials to perform highly complex surgeries. Therapeutic Studies - Investigating the Results of Treatment.
【摘要】目的:对某复杂程度较高的三级医院18岁以下需要手术治疗的脊柱侧凸患者进行登记,找出延误治疗的原因。方法:于2021年1月至2022年12月在某高复杂性三级医院脊柱骨科专科门诊亲自和自发要求进行数据收集。结果在网络数据库(Red Cap®)中进行编译。结果:共纳入59例患者,女性45例(77.9%),男性14例(22.1%),平均年龄13.7岁。病因:30例特发性(50.8%),8例综合征性(13.5%),11例神经肌肉性(18.6%),10例先天性(16.9%)。其中等待手术46例(77.9%),保守治疗13例(22.1%)。延误治疗的主要原因:术中无神经生理监测(19 - 41.3%);无法获得特定的手术材料(16 - 34.8%);转介困难(6 - 13.1%);跟踪损失(3 - 6.5%)和铸造限制(2 - 4.3%)。从诊断到第一次咨询的平均时间为17.25个月(0 - 140)。到2022年12月的平均手术等待时间为38.4个月(1 - 156)。结论:从引导脊柱侧凸患者前往专科中心到实施手术,公共卫生系统在监测和治疗的各个环节都缺乏辅助,主要原因是术中神经生理监测的使用受到限制,以及无法获得进行高度复杂手术所需的特定材料。治疗研究-调查治疗结果。
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引用次数: 0
USE OF TERIPARATIDE IN SURGICAL PLANNING FOR PATIENTS WITH OSTEOPOROSIS 特立帕肽在骨质疏松患者手术计划中的应用
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203270489
RICARDO CEPEDA JORDAN, PEDRO LUIS BAZáN, JOSé CARLOS SORIA ADARO
ABSTRACT Currently, there are no guidelines for treating osteoporosis in spinal surgery. The rate of complications such as screw loosening, proximal junction kyphosis, cage subsidence, and loss of reduction in fractures is high. Objective: To evaluate the use of teriparatide and denosumab in planning spinal surgery in an osteoporotic patient with degenerative pathology, emphasizing the fusion rate, bone mineral density, and decreased complications. Method: A systematic search was performed in medical reference databases for comparative studies of teriparatide and denosumab in spinal surgery to evaluate fusion, screw loosening, bone mineral density, and decrease in the incidence of vertebral fractures. χ2 was implemented for the statistical analysis, according to PRISMA (2020). Result: Fusion rate with teriparatide was 79.28% in the first six months, 95% CI (OR 2.62) and decreased screw loosening rate 81.9% 95% CI (OR 0.6). Increase in bone mineral density 15.5% OR 1.49 (0.77 - 2.86) and decrease in vertebral fracture rate 85.4% OR 0.5. Conclusions: Teriparatide and denosumab should be considered in perioperative spinal planning due to their effectiveness, synergism, and low adverse effects; to improve bone mineral density and decrease the rate of complications. Clinical, comparative, and statistically significant studies are required to confirm this. Level of Evidence II; Systematic Review and Meta-analysis.
目前,脊柱手术中治疗骨质疏松尚无指南。并发症的发生率很高,如螺钉松动、近端关节后凸、固定架下沉和骨折复位丧失。目的:评价特立帕肽和地诺单抗在骨质疏松伴退行性病理患者脊柱手术计划中的应用,强调融合率、骨密度和并发症的减少。方法:系统检索医学参考数据库,比较特立帕肽和地诺单抗在脊柱外科手术中的应用,评价融合、螺钉松动、骨密度和椎体骨折发生率的降低。χ2进行统计分析,参照PRISMA(2020)。结果:前6个月特立帕肽的融合率为79.28%,95% CI (OR 2.62),螺钉松动率降低81.9%,95% CI (OR 0.6)。骨密度升高15.5%或1.49(0.77 - 2.86),椎体骨折率降低85.4%或0.5。结论:特立帕肽和地诺单抗因其有效性、协同性和低不良反应,在围手术期脊柱规划中应考虑;提高骨密度,降低并发症发生率。需要临床、比较和统计上有意义的研究来证实这一点。证据水平II;系统评价和荟萃分析。
{"title":"USE OF TERIPARATIDE IN SURGICAL PLANNING FOR PATIENTS WITH OSTEOPOROSIS","authors":"RICARDO CEPEDA JORDAN, PEDRO LUIS BAZáN, JOSé CARLOS SORIA ADARO","doi":"10.1590/s1808-185120222203270489","DOIUrl":"https://doi.org/10.1590/s1808-185120222203270489","url":null,"abstract":"ABSTRACT Currently, there are no guidelines for treating osteoporosis in spinal surgery. The rate of complications such as screw loosening, proximal junction kyphosis, cage subsidence, and loss of reduction in fractures is high. Objective: To evaluate the use of teriparatide and denosumab in planning spinal surgery in an osteoporotic patient with degenerative pathology, emphasizing the fusion rate, bone mineral density, and decreased complications. Method: A systematic search was performed in medical reference databases for comparative studies of teriparatide and denosumab in spinal surgery to evaluate fusion, screw loosening, bone mineral density, and decrease in the incidence of vertebral fractures. χ2 was implemented for the statistical analysis, according to PRISMA (2020). Result: Fusion rate with teriparatide was 79.28% in the first six months, 95% CI (OR 2.62) and decreased screw loosening rate 81.9% 95% CI (OR 0.6). Increase in bone mineral density 15.5% OR 1.49 (0.77 - 2.86) and decrease in vertebral fracture rate 85.4% OR 0.5. Conclusions: Teriparatide and denosumab should be considered in perioperative spinal planning due to their effectiveness, synergism, and low adverse effects; to improve bone mineral density and decrease the rate of complications. Clinical, comparative, and statistically significant studies are required to confirm this. Level of Evidence II; Systematic Review and Meta-analysis.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136201956","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 STUDY OF THE PREVALENCE OF LOW BACK PAIN IN SPINE SURGEONS IN BRAZIL 巴西脊柱外科医生腰痛流行病学研究
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203273675
BEATRIZ FOGAROLLI AFONSO, ARTHUR FELIPE LAUF MELOTTI, ITALO BARCELLOS DE SOUZA, LUCAS RIBEIRO MACIEL, THIAGO RUIZ BARBOSA, FERNANDA ANDREA MINUTTI NAVARRO, RODRIGO YUITI NAKAO, LUIZ CLáUDIO LACERDA RODRIGUES
ABSTRACT Introduction: Low back pain is defined as pain, muscle spasm, or stiffness between the L1 and L5 vertebrae, below the lower margin of the twelfth rib and above the upper gluteal fold, and may or may not be associated with pain radiating to the lower limbs. Objective: To determine the prevalence of low back pain in spine surgeons. Method: A non-randomized quantitative cross-sectional clinical study was carried out in a sample of 95 spine surgeons in Brazil, with the application of the Oswestry and visual analog pain scales, in addition to a structured questionnaire for the characterization of the participants. Results: Among the studied population, 69.5% were orthopedists, 30.5% were neurosurgeons, and the mean age of the sample was 46 years (±10.6), with neurosurgeons being older than orthopedists. Regarding BMI, the majority (77.8%) were overweight or obese, and seventy-six percent performed physical activity. The prevalence of low back pain was 58.9%. No relevant differences were found in the time spent weekly in surgeries between those who had low back pain and those who did not (p = 0.364). Mean pain intensity was 2.0 (SD = 2.2), statistically (p = 0.025) higher in orthopedists (2.3) when compared to neurosurgeons (1.3). Regarding the ODI score, 98.2% of the surgeons had a minimal disability (0-20%) for daily activities. Conclusion: The prevalence of low back pain in spine surgeons is high and is associated with mild inability to perform daily activities. Level Of Evidence IV; Non-Randomized Quantitative Cross-Sectional Clinical Study.
摘要:腰痛被定义为L1和L5椎体之间、第十二肋骨下缘以下和臀上褶以上的疼痛、肌肉痉挛或僵硬,可能与放射到下肢的疼痛有关,也可能不相关。目的:了解脊柱外科医生腰痛的患病率。方法:对巴西95名脊柱外科医生进行非随机定量横断面临床研究,应用Oswestry和视觉模拟疼痛量表,并对参与者进行结构化问卷调查。结果:研究人群中骨科医生占69.5%,神经外科医生占30.5%,样本平均年龄为46岁(±10.6)岁,神经外科医生年龄大于骨科医生。在BMI方面,大多数人(77.8%)超重或肥胖,76%的人进行体育锻炼。腰痛患病率为58.9%。有腰痛的患者和没有腰痛的患者每周接受手术的时间没有相关差异(p = 0.364)。平均疼痛强度为2.0 (SD = 2.2),骨科医生(2.3)比神经外科医生(1.3)有统计学意义(p = 0.025)。在ODI评分方面,98.2%的外科医生有轻微的日常活动障碍(0-20%)。结论:脊柱外科医生腰痛的患病率很高,并伴有轻度不能进行日常活动。证据等级IV;非随机定量横断面临床研究。
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引用次数: 0
EPIDEMIOLOGICAL PORTRAIT OF PEDIATRIC SCOLIOSIS IN A TERTIARY HOSPITAL IN BRAZIL 巴西某三级医院小儿脊柱侧凸的流行病学调查
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203273410
SAMILLY CONCEIÇÃO MAIA MARTINS, SYLVIO MYSTRO, IVAN GUIDOLIN VEIGA, ANDRÉ FRAZÃO ROSA, MAURICIO COELHO LIMA, MARCOS ANTÔNIO TEBET, WAGNER PASQUALINI, PAULO TADEU MAIA CAVALI, MARCELO ÍTALO RISSO NETO
ABSTRACT Objective: To trace the epidemiological profile of patients with pediatric scoliosis in a tertiary hospital in the region of Campinas - SP, seeking to understand and evaluate the demand of these patients, the results of delay in treatment, and its impact on the progression of the deformity. Methods: An epidemiological, observational, and cross-sectional study was carried out in a digital database, including patients from 0 to 18 years of age, where sociodemographic variables, scoliosis classification, and institutional follow-up and treatment data were collected. Results: The sample had 30 patients who met the inclusion criteria. The age of the patients ranged from 5 years to 18 years, with a mean of 12.8 years. Neuromuscular scoliosis was the most prevalent etiology (40%), followed by congenital scoliosis (36.6%) and, to a lesser extent, idiopathic scoliosis (23.3%). The patient follow-up time between the first and last appointment has an average of 74.7 months. When the specialty monitors the patient, the initial and final Cobb angles are evaluated in degrees, with a percentage increase of 40.3%. Delay in care (outpatient care, conservative treatment, or surgery) was identified in 25 patients (83.3% of the sample). Conclusion: Most of the patients evaluated showed evolution of the scoliosis condition, especially due to the delay in care, failure to obtain surgical treatment, or even conservative treatment in an adequate time, with an increase in the magnitude of the curve and greater severity of the case. Level of Evidence III; Observational, Cross-Sectional Study.
摘要目的:追踪坎皮纳斯- SP地区某三级医院小儿脊柱侧凸患者的流行病学特征,了解和评价这些患者的需求、延误治疗的结果及其对畸形进展的影响。方法:在数字数据库中进行流行病学、观察性和横断面研究,包括0至18岁的患者,收集社会人口学变量、脊柱侧凸分类、机构随访和治疗数据。结果:样本中有30例患者符合纳入标准。患者年龄5 ~ 18岁,平均12.8岁。神经肌肉型脊柱侧凸是最常见的病因(40%),其次是先天性脊柱侧凸(36.6%),其次是特发性脊柱侧凸(23.3%)。患者第一次到最后一次就诊的随访时间平均为74.7个月。当专科监护患者时,以度来评估初始和最终Cobb角,百分比增加了40.3%。25例患者(占样本的83.3%)延误治疗(门诊治疗、保守治疗或手术)。结论:所评估的大多数患者脊柱侧凸病情均有演变,特别是由于护理延误,未能及时手术治疗,甚至保守治疗,且曲线幅度增大,病情加重。证据等级III;观察性横断面研究。
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引用次数: 0
PERSPECTIVES FROM THE 2023 38TH INTERNATIONAL ISMISS SYMPOSIUM HELD IN ZURICH, SWITZERLAND 2023年在瑞士苏黎世举行的第38届国际ismiss研讨会的观点
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203273783
KAI-UWE LEWANDROWSKI, JOACHIM OERTEL, BENEDIKT BURKHARDT, PETER WINKLER, HANSJöRG LEU
{"title":"PERSPECTIVES FROM THE 2023 38TH INTERNATIONAL ISMISS SYMPOSIUM HELD IN ZURICH, SWITZERLAND","authors":"KAI-UWE LEWANDROWSKI, JOACHIM OERTEL, BENEDIKT BURKHARDT, PETER WINKLER, HANSJöRG LEU","doi":"10.1590/s1808-185120222203273783","DOIUrl":"https://doi.org/10.1590/s1808-185120222203273783","url":null,"abstract":"","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135212861","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 ACUTE PRESENTATION OF LUMBAR FACET JOINT GANGLIA WITH BILATERAL SCIATICA 双侧坐骨神经痛伴腰椎小关节神经节的临床急性表现
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120232202273321
Carla Olim Castro, André Barros, Nuno Lança, Luís Barroso, João Cannas, Jorge Mineiro
ABSTRACT Facet joint ganglia are benign cystic lesions located adjacent to a facet joint. The majority is asymptomatic. However, can cause important low-back pain and radiculopathy. Neurogenic deficit, claudication, and cauda equina syndrome have also been reported. The authors report two cases of acute low back pain with bilateral sciatica, dorsal foot dysesthesia, and hallux dorsiflexion/extension deficit, due to the presence of encapsulated cysts adjacent to the facet joints causing a significant reduction of the spinal canal. Urgent surgical decompression was performed in both patients with an uneventful recovery. Symptomatic facet joint ganglia is a highly unusual cause of back pain, although it can present with acute onset of bilateral sciatica and canal stenosis requiring urgent surgical decompression. This paper highlights facet joint synovial as a differential diagnosis of lumbar pain and describes two different surgical approaches with good outcomes. Level of Evidence IV; Case Series.
小关节神经节是位于小关节附近的良性囊性病变。大多数是无症状的。然而,可引起重要的腰痛和神经根病。神经源性缺陷、跛行和马尾综合征也有报道。作者报告了两例急性腰痛伴双侧坐骨神经痛、足背感觉障碍和拇背屈/伸缺陷的病例,原因是关节突关节附近存在囊状囊肿,导致椎管明显复位。两例患者均行紧急手术减压,均顺利恢复。症状性小关节神经节是一种非常罕见的背部疼痛的原因,尽管它可以出现急性发作的双侧坐骨神经痛和需要紧急手术减压的椎管狭窄。本文强调小关节滑膜作为腰椎疼痛的鉴别诊断,并描述了两种不同的手术方法,效果良好。证据水平IV;病例系列。
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引用次数: 0
THIRTY-DAY UNPLANNED READMISSION AFTER SPINE SURGERY: ANALYSIS OF 650 CASES 650例脊柱手术后30天意外再入院分析
Q4 Medicine Pub Date : 2023-01-01 DOI: 10.1590/s1808-185120222203274615
FRANÇOIS DANTAS, ANTÔNIO CARLOS VIEIRA CAIRES, MARCO TÚLIO DOMINGOS SILVA E REIS, GUSTAVO AGRA CARIRI, BRÁULIO ROBERTO GONÇALVES MARINHO COUTO, RICARDO VIEIRA BOTELHO, FERNANDO LUIZ ROLEMBERG DANTAS
ABSTRACT Objective: Postoperative readmission rates can be used to assess hospital care quality. The rates of unplanned readmission within 30 days after spine surgery are variable in the literature, and no studies have evaluated such rates in a single Latin American center. This study aimed to assess the rate of unplanned hospital readmission within 30 days after a spine surgery at a single Brazilian institution and to identify possible risk factors. Methods: Patients who underwent spine surgery at a single private hospital between January 2018 and December 2020 were retrospectively analyzed, and those with unplanned readmissions within 30 days of discharge were identified. Risk factors were determined, and the reoperation rate was assessed. Results: 650 patients were included in the analysis, and 74 (11.28%) were readmitted within 30 days after surgery. Higher readmission rates were observed after vertebroplasty and surgeries involving spinal or bone tumors. The risk factors found in the series were older age, longer hospital stays, higher ASA scores, instrumented surgeries, diabetes mellitus, and surgeries involving primary or secondary spinal tumors. The most common causes of unplanned readmission were infection and pain. Of the readmissions, 28.37% required a return to the operating room. Conclusions: This study suggests infection and pain management were the most common causes of unplanned readmission after spine surgery. Strategies to improve perioperative and postoperative care are required to reduce unplanned readmissions. Level of Evidence III; Retrospective Comparative Study.
【摘要】目的:术后再入院率可用于评价医院护理质量。脊柱手术后30天内的意外再入院率在文献中是可变的,没有研究在单一的拉丁美洲中心评估过这样的比率。本研究旨在评估巴西一家机构脊柱手术后30天内意外再入院率,并确定可能的危险因素。方法:回顾性分析2018年1月至2020年12月在一家私立医院接受脊柱手术的患者,并确定出院后30天内计划外再入院的患者。确定危险因素,评估再手术率。结果:650例患者纳入分析,术后30天内再入院74例(11.28%)。椎体成形术和涉及脊柱或骨肿瘤的手术后观察到更高的再入院率。在该系列研究中发现的危险因素包括年龄较大、住院时间较长、ASA评分较高、器械手术、糖尿病以及涉及原发性或继发性脊柱肿瘤的手术。意外再入院的最常见原因是感染和疼痛。再入院患者中,28.37%需要返回手术室。结论:本研究提示感染和疼痛处理是脊柱手术后意外再入院的最常见原因。需要改善围手术期和术后护理的策略来减少计划外再入院。证据等级III;回顾性比较研究。
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Coluna/ Columna
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