Pub Date : 2023-01-01DOI: 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.
{"title":"EPIDEMIOLOGICAL PROFILE IN A TERTIARY ADMISSION UNIT OF SPINE DISEASES","authors":"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","doi":"10.1590/s1808-185120222203272944","DOIUrl":"https://doi.org/10.1590/s1808-185120222203272944","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136203661","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}
Pub Date : 2023-01-01DOI: 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":null,"pages":null},"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}
Pub Date : 2023-01-01DOI: 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.
{"title":"EPIDEMIOLOGICAL STUDY OF THE PREVALENCE OF LOW BACK PAIN IN SPINE SURGEONS IN BRAZIL","authors":"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","doi":"10.1590/s1808-185120222203273675","DOIUrl":"https://doi.org/10.1590/s1808-185120222203273675","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136203036","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}
Pub Date : 2023-01-01DOI: 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.
{"title":"EPIDEMIOLOGICAL PORTRAIT OF PEDIATRIC SCOLIOSIS IN A TERTIARY HOSPITAL IN BRAZIL","authors":"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","doi":"10.1590/s1808-185120222203273410","DOIUrl":"https://doi.org/10.1590/s1808-185120222203273410","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134883494","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}
Pub Date : 2023-01-01DOI: 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.
{"title":"PREVALENCE OF SPINAL DISEASES IN PRACTITIONERS OF BODYBUILDING","authors":"NATAN WILD, CAROLINE ANDREAZZA","doi":"10.1590/s1808-185120222203273480","DOIUrl":"https://doi.org/10.1590/s1808-185120222203273480","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135213109","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}
Pub Date : 2023-01-01DOI: 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.
{"title":"THORACIC-LUMBAR ARTHRODESIS VIA EXTREME LATERAL APPROACH: A RETROSPECTIVE STUDY","authors":"FELIPI FERREIRA LAZZARI, ÁLYNSON LAROCCA KULCHESKI, ANDRé LUIS SEBBEN, PEDRO GREIN DEL SANTORO, MARCEL LUIZ BENATO, MARIA EDUARDA PEREIRA CARGNIN, XAVIER SOLER GRAELLS","doi":"10.1590/s1808-185120222203250452","DOIUrl":"https://doi.org/10.1590/s1808-185120222203250452","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135213361","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}
Pub Date : 2023-01-01DOI: 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.
{"title":"STUDY ON PEDIATRIC SCOLIOSIS PATIENTS AT HOSPITAL SANTA CASA DE MISERICÓRDIA IN SÃO PAULO","authors":"FELIPE NEVES SIMõES MONTEIRO, MURILO ALEXANDRE, WILLIAM ZARZA SANTOS, RODRIGO GóES MEDEA DE MENDONÇA, ALBERTO OFENHEJM GOTFRYD, MARIA FERNANDA SILBER CAFFARO, ROBERT MEVES","doi":"10.1590/s1808-185120222203273284","DOIUrl":"https://doi.org/10.1590/s1808-185120222203273284","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135214467","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}
Pub Date : 2023-01-01DOI: 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.
{"title":"CLINICAL ACUTE PRESENTATION OF LUMBAR FACET JOINT GANGLIA WITH BILATERAL SCIATICA","authors":"Carla Olim Castro, André Barros, Nuno Lança, Luís Barroso, João Cannas, Jorge Mineiro","doi":"10.1590/s1808-185120232202273321","DOIUrl":"https://doi.org/10.1590/s1808-185120232202273321","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135450740","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}
Pub Date : 2023-01-01DOI: 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.
{"title":"THIRTY-DAY UNPLANNED READMISSION AFTER SPINE SURGERY: ANALYSIS OF 650 CASES","authors":"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","doi":"10.1590/s1808-185120222203274615","DOIUrl":"https://doi.org/10.1590/s1808-185120222203274615","url":null,"abstract":"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.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134882739","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}
Pub Date : 2023-01-01DOI: 10.1590/s1808-185120222203273367
RAFAEL MAGALHãES GRANA, SAMILLY CONCEIÇÃO MAIA MARTINS, SYLVIO MISTRO NETO, IVAN GUIDOLIN VEIGA, ANDRÉ FRAZÃOROSA, MAURICIO COELHO LIMAL, MARCOS ANTÔNIO TEBET, WAGNER PASQUALINI, PAULO TADEU MAIA CAVALI, MARCELO ITALO RISSO NETO
ABSTRACT The objective of this study was to conduct a systematic literature review to evaluate the impact of perioperative blood loss reduction and blood transfusion rate in patients undergoing adolescent idiopathic scoliosis correction surgery and to correlate these results with the different doses of tranexamic acid used in the literature. Ten databases (BVS, COCHRANE, EBSCOHOST, EMBASE, EPISTEMONIKOS, PROQUEST, PUBMED PMC, PUBMED, SCOPUS, WEB OF SCIENCE) were searched to find studies on the effectiveness of tranexamic acid in idiopathic scoliosis surgery. The mean differences in bleeding and transfusions were combined using a random-effects meta-analysis. A total of 17 studies with 1608 patients were included in the evaluation, demonstrating an Odds Ratio of 2.8 (95% CI: 0.8-4.3) as a measure of association for the risk of bleeding and transfusion in the control group (non-users of tranexamic acid), efficiency in reducing bleeding (p=0.03). Additionally, a mean reduction in bleeding of approximately 700 ml was observed. There was no statistical difference between the doses used. The systematic review showed that tranexamic acid effectively reduces bleeding and the need for transfusions, but there were no significant differences in the results between different doses of tranexamic acid. Level of Evidence II; Systematic Review.
本研究的目的是进行系统的文献综述，以评估青少年特发性脊柱侧凸矫正手术患者围手术期减少失血量和输血率的影响，并将这些结果与文献中使用的不同剂量氨甲环酸联系起来。我们检索了10个数据库(BVS、COCHRANE、EBSCOHOST、EMBASE、EPISTEMONIKOS、PROQUEST、PUBMED PMC、PUBMED、SCOPUS、WEB OF SCIENCE)，以查找有关氨环酸在特发性脊柱侧凸手术中的有效性的研究。出血和输血的平均差异采用随机效应荟萃分析。共有17项研究纳入了1608例患者，显示出2.8的优势比(95% CI: 0.8-4.3)作为对照组(不使用氨甲环酸)出血和输血风险的关联指标，减少出血的效率(p=0.03)。此外，观察到出血平均减少约700毫升。使用的剂量之间没有统计学差异。系统评价显示氨甲环酸可有效减少出血和输血需求，但不同剂量氨甲环酸的结果无显著差异。证据水平II;系统的回顾。
{"title":"TRANEXAMIC ACID IN ADOLESCENT SCOLIOSIS SURGERY: A SYSTEMATIC REVIEW","authors":"RAFAEL MAGALHãES GRANA, SAMILLY CONCEIÇÃO MAIA MARTINS, SYLVIO MISTRO NETO, IVAN GUIDOLIN VEIGA, ANDRÉ FRAZÃOROSA, MAURICIO COELHO LIMAL, MARCOS ANTÔNIO TEBET, WAGNER PASQUALINI, PAULO TADEU MAIA CAVALI, MARCELO ITALO RISSO NETO","doi":"10.1590/s1808-185120222203273367","DOIUrl":"https://doi.org/10.1590/s1808-185120222203273367","url":null,"abstract":"ABSTRACT The objective of this study was to conduct a systematic literature review to evaluate the impact of perioperative blood loss reduction and blood transfusion rate in patients undergoing adolescent idiopathic scoliosis correction surgery and to correlate these results with the different doses of tranexamic acid used in the literature. Ten databases (BVS, COCHRANE, EBSCOHOST, EMBASE, EPISTEMONIKOS, PROQUEST, PUBMED PMC, PUBMED, SCOPUS, WEB OF SCIENCE) were searched to find studies on the effectiveness of tranexamic acid in idiopathic scoliosis surgery. The mean differences in bleeding and transfusions were combined using a random-effects meta-analysis. A total of 17 studies with 1608 patients were included in the evaluation, demonstrating an Odds Ratio of 2.8 (95% CI: 0.8-4.3) as a measure of association for the risk of bleeding and transfusion in the control group (non-users of tranexamic acid), efficiency in reducing bleeding (p=0.03). Additionally, a mean reduction in bleeding of approximately 700 ml was observed. There was no statistical difference between the doses used. The systematic review showed that tranexamic acid effectively reduces bleeding and the need for transfusions, but there were no significant differences in the results between different doses of tranexamic acid. Level of Evidence II; Systematic Review.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134884202","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}
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