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":"308 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":"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}
Pub Date : 2022-01-01DOI: 10.1590/s1808-185120222101246193
Renato Teixeira Conceição Júnior, Rui Nei de Araújo Santana Júnior
ABSTRACT Objectives: To compare microdiscectomy (MD) and endoscopic interlaminar discectomy (EID) as methods for the surgical treatment of lumbar disc herniation, describing their efficiency in reducing hospitalization time, pain, and neurological deficit, and comparing the findings and the quality of studies that used the microscopic and endoscopic techniques. Methods: A systematic literature review that used the PRISMA protocol as a methodology. The search was conducted in the PUBMED/MEDLINE and The Cochrane Library databases, using publications from the last 5 years in Portuguese and English. After applying the inclusion and exclusion criteria and validating the qualified studies via STROBE and CONSORT, there were a total of 16 studies for data compilation. Results: A sample of 1004 patients who underwent lumbar discectomy was obtained, 62% of whom were male, and 493 of whom underwent EID (49%) and 511 MD (51%). The mean patient age was 38.7 years and the predominant vertebral level operated was L5-S1 (64.8%). The EID had shorter surgical time (66.38 min) and hospitalization time (3.3 days), in addition to greater variation in the VAS LLLL score (5.38), while the MD presented greater variation in the VAS LUMBAR score (3.14). Conclusion: EID demonstrated efficacy like that of MD, given the similarity in the results obtained, in addition to non-inferiority in the reduction of pain and neurological deficit, and superiority in surgical and hospitalization times. Level of Evidence I; Systematic review .
{"title":"THE MICROSCOPIC AND ENDOSCOPIC TECHNIQUES IN LUMBAR DISCECTOMY: A SYSTEMATIC REVIEW","authors":"Renato Teixeira Conceição Júnior, Rui Nei de Araújo Santana Júnior","doi":"10.1590/s1808-185120222101246193","DOIUrl":"https://doi.org/10.1590/s1808-185120222101246193","url":null,"abstract":"ABSTRACT Objectives: To compare microdiscectomy (MD) and endoscopic interlaminar discectomy (EID) as methods for the surgical treatment of lumbar disc herniation, describing their efficiency in reducing hospitalization time, pain, and neurological deficit, and comparing the findings and the quality of studies that used the microscopic and endoscopic techniques. Methods: A systematic literature review that used the PRISMA protocol as a methodology. The search was conducted in the PUBMED/MEDLINE and The Cochrane Library databases, using publications from the last 5 years in Portuguese and English. After applying the inclusion and exclusion criteria and validating the qualified studies via STROBE and CONSORT, there were a total of 16 studies for data compilation. Results: A sample of 1004 patients who underwent lumbar discectomy was obtained, 62% of whom were male, and 493 of whom underwent EID (49%) and 511 MD (51%). The mean patient age was 38.7 years and the predominant vertebral level operated was L5-S1 (64.8%). The EID had shorter surgical time (66.38 min) and hospitalization time (3.3 days), in addition to greater variation in the VAS LLLL score (5.38), while the MD presented greater variation in the VAS LUMBAR score (3.14). Conclusion: EID demonstrated efficacy like that of MD, given the similarity in the results obtained, in addition to non-inferiority in the reduction of pain and neurological deficit, and superiority in surgical and hospitalization times. Level of Evidence I; Systematic review .","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67478322","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 : 2022-01-01DOI: 10.1590/s1808-185120222102258674
C. Romão, C. Mercê, Marco António Colaço Branco
ABSTRACT Objective: I) To investigate the influence of physical activity (PA) on levels of low back pain, and II) To classify the respondents regarding low back pain. Methods: Collection of responses, through an online questionnaire, from 199 adults aged between 18 and 65 years (36.05 ± 11.90 years). The following inclusion criteria were applied: I) Suffering or have suffered pain in the spine at some point in life; and as an exclusion criterion: I) Being outside the required age range. Results: Investigating the level of pain and the risk of low back pain, there was a significant association (r = 0.481; p≤0.01) between these two factors, indicating that the higher the levels of pain, the higher the risk of low back pain. Those who presented higher levels of chronic pain either did not practice any physical activity (58.8%), or practiced formal PA (42.9%) or practiced informal PA (30.7%). Those who had practiced physical exercise for three months or more mostly did not have chronic pain (70.1%). Conclusions: There was a decrease in chronic low back pain which was associated with increased time and frequency of PA, as well as the practice of postural physical exercises. Level of Evidence I; Prognostic Studies— Investigating the Effect of a Patient Characteristic on the Outcome of Disease.
{"title":"THE INFLUENCE OF PHYSICAL ACTIVITY ON THE PREVALENCE OF LOW BACK PAIN AMONG THE PORTUGUESE POPULATION","authors":"C. Romão, C. Mercê, Marco António Colaço Branco","doi":"10.1590/s1808-185120222102258674","DOIUrl":"https://doi.org/10.1590/s1808-185120222102258674","url":null,"abstract":"ABSTRACT Objective: I) To investigate the influence of physical activity (PA) on levels of low back pain, and II) To classify the respondents regarding low back pain. Methods: Collection of responses, through an online questionnaire, from 199 adults aged between 18 and 65 years (36.05 ± 11.90 years). The following inclusion criteria were applied: I) Suffering or have suffered pain in the spine at some point in life; and as an exclusion criterion: I) Being outside the required age range. Results: Investigating the level of pain and the risk of low back pain, there was a significant association (r = 0.481; p≤0.01) between these two factors, indicating that the higher the levels of pain, the higher the risk of low back pain. Those who presented higher levels of chronic pain either did not practice any physical activity (58.8%), or practiced formal PA (42.9%) or practiced informal PA (30.7%). Those who had practiced physical exercise for three months or more mostly did not have chronic pain (70.1%). Conclusions: There was a decrease in chronic low back pain which was associated with increased time and frequency of PA, as well as the practice of postural physical exercises. Level of Evidence I; Prognostic Studies— Investigating the Effect of a Patient Characteristic on the Outcome of Disease.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479182","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 : 2022-01-01DOI: 10.1590/s1808-185120222103257247
William Jolli DE Araujo, Matheus Siqueira Bastos, Marco Aurélio Serafim Bonvino
ABSTRACT Objective: To compare the level of activation of the lumbar spine stabilizing muscles between people with chronic low back pain and healthy people. Methods: A systematic search was performed on May 10, 2021, of the following databases: PubMed, Physiotherapy Evidence Database and Cochrane Library. Inclusion and exclusion criteria were based on the PICO format. Two authors independently examined all articles that were selected for full reading. Disagreements were resolved through a discussion between the authors. Results: The bibliographical search identified 525 records, 165 of which were duplicates. After screening the titles, abstracts and the full text of the remaining 360 studies, 352 articles were excluded, and 8 articles were included in this review. The eight studies assessed the level of muscle activation in patients with chronic low back pain. In six studies patients with chronic low back pain had a higher activation level, in one study there was no statistically significant difference between groups,and in one study the activation level was lower in the chronic low back pain group. Discussion: This review was the first to review electromyography studies of the lumbar spine stabilizer muscles, covering all types of exposure procedures for evaluation. We believe that the recommendation of healthcare professionals for these patients to contract the stabilizer muscles are totally unnecessary. Conclusion: Patients with low back pain have a higher level of lumbar spine stabilizer muscle activation than healthy people. Level of evidence IIA; Systematic review of cohort studies.
{"title":"ACTIVATION OF LUMBAR SPINE STABILIZER MUSCLES IN PEOPLE WITH CHRONIC LOW BACK PAIN: A SYSTEMATIC REVIEW","authors":"William Jolli DE Araujo, Matheus Siqueira Bastos, Marco Aurélio Serafim Bonvino","doi":"10.1590/s1808-185120222103257247","DOIUrl":"https://doi.org/10.1590/s1808-185120222103257247","url":null,"abstract":"ABSTRACT Objective: To compare the level of activation of the lumbar spine stabilizing muscles between people with chronic low back pain and healthy people. Methods: A systematic search was performed on May 10, 2021, of the following databases: PubMed, Physiotherapy Evidence Database and Cochrane Library. Inclusion and exclusion criteria were based on the PICO format. Two authors independently examined all articles that were selected for full reading. Disagreements were resolved through a discussion between the authors. Results: The bibliographical search identified 525 records, 165 of which were duplicates. After screening the titles, abstracts and the full text of the remaining 360 studies, 352 articles were excluded, and 8 articles were included in this review. The eight studies assessed the level of muscle activation in patients with chronic low back pain. In six studies patients with chronic low back pain had a higher activation level, in one study there was no statistically significant difference between groups,and in one study the activation level was lower in the chronic low back pain group. Discussion: This review was the first to review electromyography studies of the lumbar spine stabilizer muscles, covering all types of exposure procedures for evaluation. We believe that the recommendation of healthcare professionals for these patients to contract the stabilizer muscles are totally unnecessary. Conclusion: Patients with low back pain have a higher level of lumbar spine stabilizer muscle activation than healthy people. Level of evidence IIA; Systematic review of cohort studies.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479374","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 : 2022-01-01DOI: 10.1590/s1808-185120222103262527
Luis Felipe Maielli, M. Tebet, André Frazão Rosa, M. Lima, Sylvio Mistro Neto, P. Cavali, Wagner Pasqualini, Marcelo ítalo Risso Neto
ABSTRACT Aim: To conduct a systematic review of the literature to identify risk factors associated with 30-day readmission of patients submitted to anterior or posterior access cervical spine surgery. Methods: The databases used to select the papers were PubMed, Web of Science, and Cochrane, using the following search strategy: patient AND readmission AND (30 day OR “thirty day” OR 30-day OR thirty-day) AND (spine AND cervical). Results: Initially, 179 papers that satisfied the established search stringwere selected. After reading the titles and abstracts, 46 were excluded from the sample for not effectively discussing the theme proposed for this review. Of the 133 remaining papers, 109 were also excluded after a detailed reading of their content, leaving 24 that were included in the sample for the meta-analysis. Conclusions: The average readmission rate in the studies evaluated was 4.85%. Only the occurrence of infections, as well as the presence of patients classified by the American Society of Anesthesiology (ASA) assessment system with scores greater than III, were causal factors that influenced the readmission of patients. No significant differences were noted when comparing the anterior and posterior surgical access routes. Level of evidence II; Systematic Review of Level II or Level I Studies with discrepant results.
目的:对文献进行系统回顾，以确定颈椎前路或后路手术患者30天再入院的相关危险因素。方法:选择PubMed、Web of Science和Cochrane数据库，采用以下检索策略:患者和再入院(30天或“30天”或30天或30天)和(脊柱和颈椎)。结果:初步筛选出179篇满足检索条件的论文。在阅读标题和摘要后，46篇因未能有效讨论本综述提出的主题而被排除在样本之外。在剩下的133篇论文中，在详细阅读了它们的内容后，109篇也被排除在外，留下24篇被纳入meta分析的样本。结论:本研究的平均再入院率为4.85%。只有感染的发生，以及美国麻醉学学会(ASA)评估系统评分大于III的患者是影响患者再入院的原因。前后路手术通路比较无明显差异。证据等级II;对结果不一致的II级或I级研究进行系统评价。
{"title":"IDENTIFICATION OF RISK FACTORS ASSOCIATED WITH 30-DAY READMISSION OF PATIENTS SUBMITTED TO ANTERIOR OR POSTERIOR ACCESS CERVICAL SPINE SURGERY","authors":"Luis Felipe Maielli, M. Tebet, André Frazão Rosa, M. Lima, Sylvio Mistro Neto, P. Cavali, Wagner Pasqualini, Marcelo ítalo Risso Neto","doi":"10.1590/s1808-185120222103262527","DOIUrl":"https://doi.org/10.1590/s1808-185120222103262527","url":null,"abstract":"ABSTRACT Aim: To conduct a systematic review of the literature to identify risk factors associated with 30-day readmission of patients submitted to anterior or posterior access cervical spine surgery. Methods: The databases used to select the papers were PubMed, Web of Science, and Cochrane, using the following search strategy: patient AND readmission AND (30 day OR “thirty day” OR 30-day OR thirty-day) AND (spine AND cervical). Results: Initially, 179 papers that satisfied the established search stringwere selected. After reading the titles and abstracts, 46 were excluded from the sample for not effectively discussing the theme proposed for this review. Of the 133 remaining papers, 109 were also excluded after a detailed reading of their content, leaving 24 that were included in the sample for the meta-analysis. Conclusions: The average readmission rate in the studies evaluated was 4.85%. Only the occurrence of infections, as well as the presence of patients classified by the American Society of Anesthesiology (ASA) assessment system with scores greater than III, were causal factors that influenced the readmission of patients. No significant differences were noted when comparing the anterior and posterior surgical access routes. Level of evidence II; Systematic Review of Level II or Level I Studies with discrepant results.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479504","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 : 2022-01-01DOI: 10.1590/s1808-185120222102234612
L. Kim, Nelson Astur Neto, R. Mendonça, A. Gotfryd, M. F. Caffaro, Carol Carolina Corritori Coviello, T. Ribeiro, G. Klautau, M. Salles, R. Meves
ABSTRACT Objective: To evaluate the epidemiological characteristics of postoperative infection in surgeries of the spine with instrumentation in our service, and whether there is a correlation between the rate of postoperative infection and the etiology of the indication for the primary surgical procedure. Methodology: A retrospective search through medical records of patients who underwent spinal surgery with instrumentation in our hospital between 2015 and 2019 was performed, and the ones that evolved with acute or chronic postoperative infection with need for surgical cleaning to resolve it were selected. Cases of non-instrumented surgery, primary infection of the spine (osteomyelitis and spondylodiscitis) and superficial infection of the surgical wound without the need for surgical cleaning were excluded. Results: The rate of postoperative infection was 11.6%. In this group of patients who evolved with this complication, most were submitted to surgery primarily for trauma (38.9%), followed by degenerative disease (30.8%), neoplasm (19.2%), and deformity (15, 4%). However, when we analyzed these patients comparing them with the total number of cases of spinal surgery with instrumentation performed in the period, we obtained a higher prevalence of infection in patients operated for deformity (17.6%), followed by degenerative disease (13%), neoplasm (11.4%) and trauma (9.9%). This difference did not prove to be statistically significant (p = 0.79), nor the correlation with sex and age. Conclusion: In our study, proportionally, there was a difference in the prevalence of postoperative infection according to the etiological indication, being higher in cases operated for deformity, mainly due to neuromuscular disease. Level of evidence IV; A case series therapeutic study.
{"title":"CORRELATION OF POSTOPERATIVE INFECTION WITH THE ETIOLOGY OF THE DISEASE IN SPINAL SURGERY WITH INSTRUMENTATION","authors":"L. Kim, Nelson Astur Neto, R. Mendonça, A. Gotfryd, M. F. Caffaro, Carol Carolina Corritori Coviello, T. Ribeiro, G. Klautau, M. Salles, R. Meves","doi":"10.1590/s1808-185120222102234612","DOIUrl":"https://doi.org/10.1590/s1808-185120222102234612","url":null,"abstract":"ABSTRACT Objective: To evaluate the epidemiological characteristics of postoperative infection in surgeries of the spine with instrumentation in our service, and whether there is a correlation between the rate of postoperative infection and the etiology of the indication for the primary surgical procedure. Methodology: A retrospective search through medical records of patients who underwent spinal surgery with instrumentation in our hospital between 2015 and 2019 was performed, and the ones that evolved with acute or chronic postoperative infection with need for surgical cleaning to resolve it were selected. Cases of non-instrumented surgery, primary infection of the spine (osteomyelitis and spondylodiscitis) and superficial infection of the surgical wound without the need for surgical cleaning were excluded. Results: The rate of postoperative infection was 11.6%. In this group of patients who evolved with this complication, most were submitted to surgery primarily for trauma (38.9%), followed by degenerative disease (30.8%), neoplasm (19.2%), and deformity (15, 4%). However, when we analyzed these patients comparing them with the total number of cases of spinal surgery with instrumentation performed in the period, we obtained a higher prevalence of infection in patients operated for deformity (17.6%), followed by degenerative disease (13%), neoplasm (11.4%) and trauma (9.9%). This difference did not prove to be statistically significant (p = 0.79), nor the correlation with sex and age. Conclusion: In our study, proportionally, there was a difference in the prevalence of postoperative infection according to the etiological indication, being higher in cases operated for deformity, mainly due to neuromuscular disease. Level of evidence IV; A case series therapeutic study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479526","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 : 2022-01-01DOI: 10.1590/s1808-185120222103263573
Guilherme Gago da Silva, J. Britz, Otávio Garcia Martins, N. Ferreira, M. Ferreira, P. Worm
ABSTRACT Background: Spinal cord compression is a common complication of spine metastasis and multiple myeloma. About 30% of patients with cancer develop symptomatic spinal metastases during their illness. Prompt diagnosis and surgical treatment of these lesions, although palliative, are likely to reduce the morbidity and improve quality of life by improving ambulatory function. Study Design: Retrospective review of medical records. Objective: To evaluate postoperative functional recovery and the epidemiological profile of neoplastic spinal cord compression in two neurosurgical centers in southern Brazil. Methods: We retrospectively analyzed the data of all patients who underwent palliative surgery for symptomatic neoplastic spine lesion from metastatic cancer, in two neurosurgical centers, between January 2003 and July 2021. The variables age, sex, neurological status, histological type, affected segment, complications and length of hospitalization were analyzed. Results: A total of 82 patients were included. The lesions occurred in the thoracic spine in 60 cases. At admission, 95% of the patients had neurological deficits, most of which were Frankel C (37%). At histopathological analysis, breast cancer was the most common primary site. After surgery, the neurological status of 46 patients (56%) was reclassified according to the Frankel scale. Of these, 22 (47%) regained ambulatory capacity. Conclusion: Surgical treatment of metastatic spinal cord compression improved neurological status and ambulatory ability in our sample. Level of evidence II; Retrospective study.
{"title":"IMPACT OF SURGERY ON AMBULATORY STATUS IN PATIENTS WITH SYMPTOMATIC NEOPLASTIC SPINAL CORD COMPRESSION IN SOUTHERN BRAZIL","authors":"Guilherme Gago da Silva, J. Britz, Otávio Garcia Martins, N. Ferreira, M. Ferreira, P. Worm","doi":"10.1590/s1808-185120222103263573","DOIUrl":"https://doi.org/10.1590/s1808-185120222103263573","url":null,"abstract":"ABSTRACT Background: Spinal cord compression is a common complication of spine metastasis and multiple myeloma. About 30% of patients with cancer develop symptomatic spinal metastases during their illness. Prompt diagnosis and surgical treatment of these lesions, although palliative, are likely to reduce the morbidity and improve quality of life by improving ambulatory function. Study Design: Retrospective review of medical records. Objective: To evaluate postoperative functional recovery and the epidemiological profile of neoplastic spinal cord compression in two neurosurgical centers in southern Brazil. Methods: We retrospectively analyzed the data of all patients who underwent palliative surgery for symptomatic neoplastic spine lesion from metastatic cancer, in two neurosurgical centers, between January 2003 and July 2021. The variables age, sex, neurological status, histological type, affected segment, complications and length of hospitalization were analyzed. Results: A total of 82 patients were included. The lesions occurred in the thoracic spine in 60 cases. At admission, 95% of the patients had neurological deficits, most of which were Frankel C (37%). At histopathological analysis, breast cancer was the most common primary site. After surgery, the neurological status of 46 patients (56%) was reclassified according to the Frankel scale. Of these, 22 (47%) regained ambulatory capacity. Conclusion: Surgical treatment of metastatic spinal cord compression improved neurological status and ambulatory ability in our sample. Level of evidence II; Retrospective study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479599","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 : 2022-01-01DOI: 10.1590/s1808-185120222103264579
P. Bazán, Ricardo Cepeda Jordan, Juan Romel Medina Cevallos, A. O. G. Adaro, J. C. S. Adaro
ABSTRACT Bone mineral density is a crucial factor in the success or failure of osteosynthesis in spine surgery; it shows the onset of osteoporosis and related complications. Its evaluation is verified by dual-energy X-ray absorptiometry (DEXA) and Hounsfield Unit (HU) measurement by CT scan. Objective: Determine the use of HU in surgical planning; compare utility in diagnosing osteoporosis by DEXA; and evaluate sensitivity in predicting complications. Method: A systemic literature review was conducted on PubMed, in line with PRISMA methodology. Including those who justified the use of pre-surgical planning, compared HU/DEXA, and assessed complications. For the statistical analysis, the χ2 was used. Results: 57 articles were identified by selecting nine that met the inclusion criteria. In patients undergoing spinal surgery for fixation and fusion for degenerative pathology, HU measurement showed a prevalence of osteoporosis of 58.5% (sensitivity 93.26%; specificity 90.22%), osteoporosis-associated complications of 24.5%, proper diagnosis of 71.98%, and screw release rate of 82.31%. Conclusions: UH measurement for the diagnosis of osteoporosis turns out to be more sensitive, specific, and predictive compared to DEXA, especially in elderly patients; it represents a useful tool in planning spinal surgery, minimizing the risk of complications such as screw release, fractures, pseudoarthrosis, subsidence of intersomatic devices, and kyphosis of the proximal junction. Level of evidence II; Study Design: Systematic Review and meta-analysis.
骨矿物质密度是决定脊柱手术植骨成功或失败的关键因素;它显示了骨质疏松症和相关并发症的发生。通过双能x射线吸收仪(DEXA)和Hounsfield Unit (HU) CT扫描测量验证了其评价。目的:确定HU在手术计划中的应用;DEXA在骨质疏松症诊断中的应用比较;并评估预测并发症的敏感性。方法:采用PRISMA方法学对PubMed进行系统文献综述。包括那些合理使用术前计划的患者，比较HU/DEXA，并评估并发症。统计学分析采用χ2。结果:共筛选出符合纳入标准的9篇，共鉴定出57篇。在因退行性病理而接受脊柱手术固定融合的患者中，HU测量显示骨质疏松症的患病率为58.5%(敏感性为93.26%;特异性90.22%)，骨质疏松相关并发症24.5%，正确诊断率71.98%，螺钉松解率82.31%。结论:与DEXA相比，UH测量对骨质疏松症的诊断更加敏感、特异性和预测性，特别是在老年患者中;它是规划脊柱手术的有用工具，可最大限度地减少并发症的风险，如螺钉松脱、骨折、假关节、体间装置下沉和近端关节后凸。证据等级II;研究设计:系统评价和荟萃分析。
{"title":"HOUNSFIELD UNITS USE IN SPINAL SURGERY PLANNING: SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"P. Bazán, Ricardo Cepeda Jordan, Juan Romel Medina Cevallos, A. O. G. Adaro, J. C. S. Adaro","doi":"10.1590/s1808-185120222103264579","DOIUrl":"https://doi.org/10.1590/s1808-185120222103264579","url":null,"abstract":"ABSTRACT Bone mineral density is a crucial factor in the success or failure of osteosynthesis in spine surgery; it shows the onset of osteoporosis and related complications. Its evaluation is verified by dual-energy X-ray absorptiometry (DEXA) and Hounsfield Unit (HU) measurement by CT scan. Objective: Determine the use of HU in surgical planning; compare utility in diagnosing osteoporosis by DEXA; and evaluate sensitivity in predicting complications. Method: A systemic literature review was conducted on PubMed, in line with PRISMA methodology. Including those who justified the use of pre-surgical planning, compared HU/DEXA, and assessed complications. For the statistical analysis, the χ2 was used. Results: 57 articles were identified by selecting nine that met the inclusion criteria. In patients undergoing spinal surgery for fixation and fusion for degenerative pathology, HU measurement showed a prevalence of osteoporosis of 58.5% (sensitivity 93.26%; specificity 90.22%), osteoporosis-associated complications of 24.5%, proper diagnosis of 71.98%, and screw release rate of 82.31%. Conclusions: UH measurement for the diagnosis of osteoporosis turns out to be more sensitive, specific, and predictive compared to DEXA, especially in elderly patients; it represents a useful tool in planning spinal surgery, minimizing the risk of complications such as screw release, fractures, pseudoarthrosis, subsidence of intersomatic devices, and kyphosis of the proximal junction. Level of evidence II; Study Design: Systematic Review and meta-analysis.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479641","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 : 2022-01-01DOI: 10.1590/s1808-185120222103262605
F. Paula, Ramon Oliveira Soares, G. Ribeiro, Julia Martins de Oliveira, Nelson Astur Neto, M. Kanas, D. Martins, Bruno Braga Roberto, Felipe Feres, A. Gotfryd, R. Sugino, Eliane Antonioli, M. Lenza, P. Pohl
ABSTRACT Objective: To relate the radiographic fusion rate and the surgical results in patients undergoing posterolateral arthrodesis with instrumentation of the lumbar spine for the treatment of degenerative disorders. Method: A descriptive, retrospective, case series, observational study, based on medical records and imaging studies of 76 patients over 18 years of age (39 to 88 years) who underwent posterolateral lumbar arthrodesis. Data related to the presence of comorbidities were compiled and clinical outcomes were measured using specific questionnaires collected pre-surgical and 1 year after surgery. Fusion quality, as described by Christensen, was assessed from radiographic images by two examiners. The VAS, EQ-5D and Roland Morris questionnaires were used preoperatively and 1 year after surgery to assess pain, quality of life and function, respectively. Result: It was observed improvement in pain, function and quality of life after 1 year post-surgical. Pain, measured by VAS, had a reduction from 7.92 to 3.16 (p-value <0.001), the function evaluated by the Roland Morris score, also showed a reduction from 14.90 to 7.06 (p-value <0.001) . Culminating with the improvement in quality of life, measured by the EQ-5D, where there was a median increase in the score from 0.5672 to 0.7002 (p-value = 0.002). Conclusion: The absence of radiographic fusion has no direct correlation with worse results in clinical outcomes at 01 year after surgery. Most patients showed clinical improvement with no statistical difference in relation to cases in which bone fusion was obtained. Level of evidence IV; retrospective observation.
{"title":"LUMBAR ARTHRODESIS IN DEGENERATIVE SPINE: POST OPERATIVE RESULTS AND RADIOGRAPHIC EVALUATION","authors":"F. Paula, Ramon Oliveira Soares, G. Ribeiro, Julia Martins de Oliveira, Nelson Astur Neto, M. Kanas, D. Martins, Bruno Braga Roberto, Felipe Feres, A. Gotfryd, R. Sugino, Eliane Antonioli, M. Lenza, P. Pohl","doi":"10.1590/s1808-185120222103262605","DOIUrl":"https://doi.org/10.1590/s1808-185120222103262605","url":null,"abstract":"ABSTRACT Objective: To relate the radiographic fusion rate and the surgical results in patients undergoing posterolateral arthrodesis with instrumentation of the lumbar spine for the treatment of degenerative disorders. Method: A descriptive, retrospective, case series, observational study, based on medical records and imaging studies of 76 patients over 18 years of age (39 to 88 years) who underwent posterolateral lumbar arthrodesis. Data related to the presence of comorbidities were compiled and clinical outcomes were measured using specific questionnaires collected pre-surgical and 1 year after surgery. Fusion quality, as described by Christensen, was assessed from radiographic images by two examiners. The VAS, EQ-5D and Roland Morris questionnaires were used preoperatively and 1 year after surgery to assess pain, quality of life and function, respectively. Result: It was observed improvement in pain, function and quality of life after 1 year post-surgical. Pain, measured by VAS, had a reduction from 7.92 to 3.16 (p-value <0.001), the function evaluated by the Roland Morris score, also showed a reduction from 14.90 to 7.06 (p-value <0.001) . Culminating with the improvement in quality of life, measured by the EQ-5D, where there was a median increase in the score from 0.5672 to 0.7002 (p-value = 0.002). Conclusion: The absence of radiographic fusion has no direct correlation with worse results in clinical outcomes at 01 year after surgery. Most patients showed clinical improvement with no statistical difference in relation to cases in which bone fusion was obtained. Level of evidence IV; retrospective observation.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479821","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 : 2022-01-01DOI: 10.1590/s1808-185120222104261566
Matheus Falcão Santos Marinho, L. Lucena
ABSTRACT Objective: Evaluate the impacts of postural changes and low back pain in university students. Methodology: The research is configured as a cross-sectional observational study of the field study type. Fifty university students were recruited, with or without chronic low back pain. Subjects were assessed for pain level in the lumbar spine using a Likert scale, posture was assessed by photogrammetry, and functionality was assessed using the Roland-Morris disability questionnaire. Descriptive statistics and a Chi-square test (p<0.05) were performed using the SPSS 20.0 program. Results: The frequency of chronic low back pain was 62%. Of these, 48.28% reported moderate pain in the last week. The university students did not present physical disability with a mean of 3.42 ± 3.33; the most frequent postural dysfunction was scoliosis, with 84%. There was no statistically significant relationship (p> 0.112) between postural changes and chronic low back pain. Conclusion: There was a frequency of chronic low back pain and adult scoliosis in college students. However, there was no direct and significant relationship between postural biomechanical changes and chronic low back pain. Level of evidence II; A descriptive cross-sectional study with a quantitative approach.
{"title":"POSTURAL CHANGES AND CHRONIC LUMBAR PAIN IN UNIVERSITY STUDENTS: ORIGINAL STUDY","authors":"Matheus Falcão Santos Marinho, L. Lucena","doi":"10.1590/s1808-185120222104261566","DOIUrl":"https://doi.org/10.1590/s1808-185120222104261566","url":null,"abstract":"ABSTRACT Objective: Evaluate the impacts of postural changes and low back pain in university students. Methodology: The research is configured as a cross-sectional observational study of the field study type. Fifty university students were recruited, with or without chronic low back pain. Subjects were assessed for pain level in the lumbar spine using a Likert scale, posture was assessed by photogrammetry, and functionality was assessed using the Roland-Morris disability questionnaire. Descriptive statistics and a Chi-square test (p<0.05) were performed using the SPSS 20.0 program. Results: The frequency of chronic low back pain was 62%. Of these, 48.28% reported moderate pain in the last week. The university students did not present physical disability with a mean of 3.42 ± 3.33; the most frequent postural dysfunction was scoliosis, with 84%. There was no statistically significant relationship (p> 0.112) between postural changes and chronic low back pain. Conclusion: There was a frequency of chronic low back pain and adult scoliosis in college students. However, there was no direct and significant relationship between postural biomechanical changes and chronic low back pain. Level of evidence II; A descriptive cross-sectional study with a quantitative approach.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67480093","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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