Pub Date : 2022-01-01DOI: 10.1590/s1808-185120222104262528
Murilo Alexandre, William Zarza Santos, R. Mendonça, A. Gotfryd, M. F. Caffaro, R. Meves
ABSTRACT Objective: The objective was to conduct an analytical epidemiological study to understand the profile, treatment, and outcome of patients with spinal tumors in a Brazilian Quaternary Hospital of the SUS. Methods: A retrospective cohort analysis of data from the last five years was performed. It was described qualitative characteristics evaluated by absolute and relative frequencies and quantitative characteristics by sintetized measures. Associations between characteristics were verified using chi-square tests or exact tests. Results: 92 patients met the eligibility criteria. The mean age was 56.1 years (±14.7), with 48 men (52.2%) and 44 women (47.8%). The types of tumors organized in the three proposed groups had 19 multiple myelomas (20.7%), 62 metastases (67.3%), and 11 other tumors (12%). The neurological status measured through the ASIA score was A: 5.4%, B: 22.8%, C: 26.1%, D: 35.9%, E: 9.8%. Karnofsky was prevalent in the 50-70 range with 65.2%. The total hospitalization period had a mean of 22.8±18 days, preoperatively 11.9±9.2 days, and postoperatively 10.9±14 days. Karnofsky presented lower values according to the worst ASIA (p < 0.001). A total of 12 patients (13%) died during hospitalization. The total and postoperative length of stay was longer in patients who died (p = 0.002 and p < 0.001). Conclusions: This study provides epidemiological data that allow an understanding of the profile of patients with spinal tumors in the Brazilian Public Health System. The severity of the patients is higher when compared to most of the series cases in the literature. The patients with longer hospitalization stay died. Level of evidence IV; Case series.
{"title":"PROFILE OF PATIENTS WITH SPINE TUMOR OPERATED IN A SOUTH AMERICAN REFERENCE SERVICE. EPIDEMIOLOGICAL STUDY","authors":"Murilo Alexandre, William Zarza Santos, R. Mendonça, A. Gotfryd, M. F. Caffaro, R. Meves","doi":"10.1590/s1808-185120222104262528","DOIUrl":"https://doi.org/10.1590/s1808-185120222104262528","url":null,"abstract":"ABSTRACT Objective: The objective was to conduct an analytical epidemiological study to understand the profile, treatment, and outcome of patients with spinal tumors in a Brazilian Quaternary Hospital of the SUS. Methods: A retrospective cohort analysis of data from the last five years was performed. It was described qualitative characteristics evaluated by absolute and relative frequencies and quantitative characteristics by sintetized measures. Associations between characteristics were verified using chi-square tests or exact tests. Results: 92 patients met the eligibility criteria. The mean age was 56.1 years (±14.7), with 48 men (52.2%) and 44 women (47.8%). The types of tumors organized in the three proposed groups had 19 multiple myelomas (20.7%), 62 metastases (67.3%), and 11 other tumors (12%). The neurological status measured through the ASIA score was A: 5.4%, B: 22.8%, C: 26.1%, D: 35.9%, E: 9.8%. Karnofsky was prevalent in the 50-70 range with 65.2%. The total hospitalization period had a mean of 22.8±18 days, preoperatively 11.9±9.2 days, and postoperatively 10.9±14 days. Karnofsky presented lower values according to the worst ASIA (p < 0.001). A total of 12 patients (13%) died during hospitalization. The total and postoperative length of stay was longer in patients who died (p = 0.002 and p < 0.001). Conclusions: This study provides epidemiological data that allow an understanding of the profile of patients with spinal tumors in the Brazilian Public Health System. The severity of the patients is higher when compared to most of the series cases in the literature. The patients with longer hospitalization stay died. Level of evidence IV; Case series.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67480192","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/s1808-185120222102257395
Leticia Domingos Ronzani, Hannah Bang, K. S. Kock, Phelipe Menegaz, Rafael Olívio Martins, Martins Back Netto
ABSTRACT Objective: To evaluate the temporal trends of thoracolumbar fusion procedures performed by the United Health System in Brazil from 2009 to 2019. Methods: This was an observational ecological study based on data collected from the information systems under the aegis of DATASUS, especially the Hospital Information System, which manages the Hospital Admission Authorizations (Autorizações de Internação Hospitalar - AIHs). All patients who had undergone the procedures of interest, that is, elective and emergency short and long thoracolumbar arthrodeses, were included. The temporal trends of the procedures performed in Brazil and in its five regions were calculated using polynomial regression. Results: The temporal trend of elective thoracolumbar arthrodesis decreased, while that of emergency arthrodesis increased, with the peak in 2015, followed by a marked decline. Short fusions were more frequent in both elective and emergency modalities, and the South and Central-West Regions had the highest indices of procedures per million inhabitants during the entire 2009 to 2019 period. Conclusions: The temporal trends of thoracolumbar fusions performed by SUS have decreased over the last decade, a phenomenon which may be explained by the growing criticism of indications of the procedure in the current literature. Level of evidence III; Retrospective Comparative Study.
目的:评估2009年至2019年巴西联合卫生系统实施的胸腰椎融合手术的时间趋势。方法:这是一项观察性生态学研究，基于DATASUS支持下的信息系统，特别是管理住院许可的医院信息系统(Autorizações de interna o Hospitalar - AIHs)收集的数据。所有接受过相关手术的患者，即择期和急诊胸腰椎短段和长段关节融合术。使用多项式回归计算了在巴西及其五个地区执行的程序的时间趋势。结果:择期胸腰椎融合术的时间趋势下降，而急诊融合术的时间趋势上升，在2015年达到高峰，随后明显下降。短期融合在选择性和紧急模式下都更为频繁，2009年至2019年期间，南部和中西部地区每百万居民的程序指数最高。结论:在过去十年中，SUS进行胸腰椎融合的时间趋势有所下降，这一现象可能是由于当前文献中对该手术适应症的批评越来越多。证据等级III;回顾性比较研究。
{"title":"THORACOLUMBAR FUSION IN THE UNIFIED HEALTH SYSTEM: PRE-COVID-19 TEMPORAL","authors":"Leticia Domingos Ronzani, Hannah Bang, K. S. Kock, Phelipe Menegaz, Rafael Olívio Martins, Martins Back Netto","doi":"10.1590/s1808-185120222102257395","DOIUrl":"https://doi.org/10.1590/s1808-185120222102257395","url":null,"abstract":"ABSTRACT Objective: To evaluate the temporal trends of thoracolumbar fusion procedures performed by the United Health System in Brazil from 2009 to 2019. Methods: This was an observational ecological study based on data collected from the information systems under the aegis of DATASUS, especially the Hospital Information System, which manages the Hospital Admission Authorizations (Autorizações de Internação Hospitalar - AIHs). All patients who had undergone the procedures of interest, that is, elective and emergency short and long thoracolumbar arthrodeses, were included. The temporal trends of the procedures performed in Brazil and in its five regions were calculated using polynomial regression. Results: The temporal trend of elective thoracolumbar arthrodesis decreased, while that of emergency arthrodesis increased, with the peak in 2015, followed by a marked decline. Short fusions were more frequent in both elective and emergency modalities, and the South and Central-West Regions had the highest indices of procedures per million inhabitants during the entire 2009 to 2019 period. Conclusions: The temporal trends of thoracolumbar fusions performed by SUS have decreased over the last decade, a phenomenon which may be explained by the growing criticism of indications of the procedure in the current literature. Level of evidence III; Retrospective Comparative Study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479310","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/s1808-185120222102258229
Julio Alves Ponte, Alderico Girão Campos de Barros, G. Almeida, Luiz Eduardo Carelli Teixeira da Silva, Eduardo Branco de Sousa
ABSTRACT Introduction: Spinopelvic parameters related to sagittal balance have become increasinglyimportantamong spine surgeons due to their correlation with patient satisfaction rates. Objective: The goal of this study was to evaluate changes in spinal sagittal balance after lumbar spine surgery using PLIF, the posterior lumbar interbody fusion technique. Methods: The sample consisted of adult patients with degenerative spinal disease submitted to posterior lumbar arthrodesis. Patients between 18 and 70 years of agewho underwent surgeryfrom 2015 to 2017 were included in the study and divided into short (1 level) and long arthrodesis (2 to 4 levels) groups. Radiographic analysis of the spinopelvic parameters, measured before and after lumbar arthrodesis, was conducted using the SURGIMAP software. Then we evaluated the variation between pre- and postoperative measurements and performed correlation and linear regression analyses between the parameters. Results: The sample was composed of 80 patients (48 men). The mean age was lower in the short arthrodesis group than in the long arthrodesis group (52.67 ± 9.66 years versus 59.37 ± 9.30 years, respectively; p<0.0025). Significant variations in lumbar lordosis, pelvic tilt, sagittal vertical axis, T1 pelvic angle, and pelvic incidence minus lumbar lordosis were found in both short and long arthrodesis groups. The variation was significantly larger in the long than in the short arthrodesis group. Conclusion: In adult degenerative spine disease, short and long arthrodesis of the lumbar spine by PLIF allows correction of the spinopelvic parameters. Level of evidence III; Retrospective, comparative study.
{"title":"SPINOPELVIC PARAMETERS AFTER POSTERIOR LUMBAR ARTHRODESIS IN DEGENERATIVE SPINAL DISEASES","authors":"Julio Alves Ponte, Alderico Girão Campos de Barros, G. Almeida, Luiz Eduardo Carelli Teixeira da Silva, Eduardo Branco de Sousa","doi":"10.1590/s1808-185120222102258229","DOIUrl":"https://doi.org/10.1590/s1808-185120222102258229","url":null,"abstract":"ABSTRACT Introduction: Spinopelvic parameters related to sagittal balance have become increasinglyimportantamong spine surgeons due to their correlation with patient satisfaction rates. Objective: The goal of this study was to evaluate changes in spinal sagittal balance after lumbar spine surgery using PLIF, the posterior lumbar interbody fusion technique. Methods: The sample consisted of adult patients with degenerative spinal disease submitted to posterior lumbar arthrodesis. Patients between 18 and 70 years of agewho underwent surgeryfrom 2015 to 2017 were included in the study and divided into short (1 level) and long arthrodesis (2 to 4 levels) groups. Radiographic analysis of the spinopelvic parameters, measured before and after lumbar arthrodesis, was conducted using the SURGIMAP software. Then we evaluated the variation between pre- and postoperative measurements and performed correlation and linear regression analyses between the parameters. Results: The sample was composed of 80 patients (48 men). The mean age was lower in the short arthrodesis group than in the long arthrodesis group (52.67 ± 9.66 years versus 59.37 ± 9.30 years, respectively; p<0.0025). Significant variations in lumbar lordosis, pelvic tilt, sagittal vertical axis, T1 pelvic angle, and pelvic incidence minus lumbar lordosis were found in both short and long arthrodesis groups. The variation was significantly larger in the long than in the short arthrodesis group. Conclusion: In adult degenerative spine disease, short and long arthrodesis of the lumbar spine by PLIF allows correction of the spinopelvic parameters. Level of evidence III; Retrospective, comparative study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479551","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/s1808-185120222101253789
P. Bazán, Micaela Cinalli, Felipe Lanari Zabiaur, R. Castelli, C. Silveri, José Luis Monayer, Enrique Gobbi, A. Steverlynck
ABSTRACT Introduction: Denosumab is a human monoclonal antibody that binds to the receptor activator of nuclear factor kB (RANKL), it is used in the treatment of Osteoporosis. The Giant Cell Tumor (GCT) and the Aneurysmal Bone Cyst (ABC) use the same RANKL, and for this reason this drug began to be used for its treatment. There is consensus on the use, dose-time and 12-month duration for Denosumab treatment of GCT. Not so for ABC. In unresectable, disabling or recurrent tumors, its use could be for life. The adverse events of the habitual use of the drug are known, but it is not known if these increase with time. The objective of the present work is to identify the possible adverse events of treatment with Denosumab for more than 12 months. Material and Method: Series of cases with a diagnosis of GCT or ABC in spine, treated with Denosumab for more than 12 months. Adverse events are: arthralgia, fatigue, spinal pain, pain in extremities, headache, hypokalaemia, hypocalcemia, osteonecrosis of the jaw, malignant transformation, pathological fractures. Results: Eight patients, 6 TCG and 2 ABC, with a mean age at diagnosis of 25,6 years; presenting a mean treatment of 4.18 years (range 1.7 - 8.7). Of 6 operated patients, 4 had recurrence (2 to 36 months after surgery). One patient had to suspend treatment due to necrosis of the jaw, another hypocalcemia, both returned to treatment when stabilized. Conclusions: A minor adverse event (hypocalcemia) and a major adverse event (jaw bone necrosis) were observed. Level of Evidence IV; Original.
{"title":"LONG-TERM USE OF DENOSUMAB IN GIANT CELL TUMORS AND VERTEBRAL ANEURYSMAL BONE CYSTS","authors":"P. Bazán, Micaela Cinalli, Felipe Lanari Zabiaur, R. Castelli, C. Silveri, José Luis Monayer, Enrique Gobbi, A. Steverlynck","doi":"10.1590/s1808-185120222101253789","DOIUrl":"https://doi.org/10.1590/s1808-185120222101253789","url":null,"abstract":"ABSTRACT Introduction: Denosumab is a human monoclonal antibody that binds to the receptor activator of nuclear factor kB (RANKL), it is used in the treatment of Osteoporosis. The Giant Cell Tumor (GCT) and the Aneurysmal Bone Cyst (ABC) use the same RANKL, and for this reason this drug began to be used for its treatment. There is consensus on the use, dose-time and 12-month duration for Denosumab treatment of GCT. Not so for ABC. In unresectable, disabling or recurrent tumors, its use could be for life. The adverse events of the habitual use of the drug are known, but it is not known if these increase with time. The objective of the present work is to identify the possible adverse events of treatment with Denosumab for more than 12 months. Material and Method: Series of cases with a diagnosis of GCT or ABC in spine, treated with Denosumab for more than 12 months. Adverse events are: arthralgia, fatigue, spinal pain, pain in extremities, headache, hypokalaemia, hypocalcemia, osteonecrosis of the jaw, malignant transformation, pathological fractures. Results: Eight patients, 6 TCG and 2 ABC, with a mean age at diagnosis of 25,6 years; presenting a mean treatment of 4.18 years (range 1.7 - 8.7). Of 6 operated patients, 4 had recurrence (2 to 36 months after surgery). One patient had to suspend treatment due to necrosis of the jaw, another hypocalcemia, both returned to treatment when stabilized. Conclusions: A minor adverse event (hypocalcemia) and a major adverse event (jaw bone necrosis) were observed. Level of Evidence IV; Original.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67478963","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/s1808-185120222101250514
Anderson Fellipe Matos de Souza, L. M. Ávila, C. A. Aguiar, Luís Eduardo Munhoz da Rocha
ABSTRACT Objective: To analyze the pre- and postoperative spinopelvic parameters and global sagittal balance of patients with adolescent idiopathic scoliosis (AIS) divided into 3 groups (Group 1 – thoracic arthrodesis, Group 2 - thoracolumbar arthrodesis, and Group 3 – lumbar arthrodesis), observing differences in these two moments and whether the parameter values are maintained or not over a period of up to 2 years following surgery. Methods: We analyzed the radiographs from a single-center database of 99 patients who underwent arthrodesis with posterior instrumentation. Pelvic incidence, pelvic version, sacral slope, lumbar lordosis, thoracic kyphosis, and sagittal vertical axis values were measured in the pre- and postoperative radiographies of each patient. Results: The parameters of pelvic incidence, pelvic version, sacral slope, and sagittal vertical axis did not show statistically significant differences among the 3 groups. There was a difference in preoperative lumbar lordosis between the 3 groups (p = 0.049). Thoracic kyphosis showed differences both in the pre- (p = 0.015) and postoperative (p = 0.042) values, in addition to demonstrating a relationship of dependence between the pre- and postoperative values in the final statistical analysis. Conclusion: The evaluation of the parameters analyzed shows that the study groups have similar values of individual balance, with the exception of thoracic kyphosis and lumbar lordosis, which are measurements that depend on the surgical technique and compensatory mechanisms, but remained within normal ranges. These factors allow the surgeon to be attentive to both the coronal and sagittal planes when planning the correction in order to achieve the equilibrium of the trunk in addition to correction of the deformity. Level of Evidence IIIA: Comparative retrospective study.
{"title":"PRE- AND POSTOPERATIVE COMPARATIVE ANALYSIS OF THE SPINOPELVIC AND GLOBAL SAGITTAL PARAMETERS OF PATIENTS WITH ADOLESCENT IDIOPATHIC SCOLIOSIS","authors":"Anderson Fellipe Matos de Souza, L. M. Ávila, C. A. Aguiar, Luís Eduardo Munhoz da Rocha","doi":"10.1590/s1808-185120222101250514","DOIUrl":"https://doi.org/10.1590/s1808-185120222101250514","url":null,"abstract":"ABSTRACT Objective: To analyze the pre- and postoperative spinopelvic parameters and global sagittal balance of patients with adolescent idiopathic scoliosis (AIS) divided into 3 groups (Group 1 – thoracic arthrodesis, Group 2 - thoracolumbar arthrodesis, and Group 3 – lumbar arthrodesis), observing differences in these two moments and whether the parameter values are maintained or not over a period of up to 2 years following surgery. Methods: We analyzed the radiographs from a single-center database of 99 patients who underwent arthrodesis with posterior instrumentation. Pelvic incidence, pelvic version, sacral slope, lumbar lordosis, thoracic kyphosis, and sagittal vertical axis values were measured in the pre- and postoperative radiographies of each patient. Results: The parameters of pelvic incidence, pelvic version, sacral slope, and sagittal vertical axis did not show statistically significant differences among the 3 groups. There was a difference in preoperative lumbar lordosis between the 3 groups (p = 0.049). Thoracic kyphosis showed differences both in the pre- (p = 0.015) and postoperative (p = 0.042) values, in addition to demonstrating a relationship of dependence between the pre- and postoperative values in the final statistical analysis. Conclusion: The evaluation of the parameters analyzed shows that the study groups have similar values of individual balance, with the exception of thoracic kyphosis and lumbar lordosis, which are measurements that depend on the surgical technique and compensatory mechanisms, but remained within normal ranges. These factors allow the surgeon to be attentive to both the coronal and sagittal planes when planning the correction in order to achieve the equilibrium of the trunk in addition to correction of the deformity. Level of Evidence IIIA: Comparative retrospective study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479056","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/s1808-185120222102258863
Bruno Landal Cavassin, Carolina Cabral Brandalizze, Gabriel Wielisvky Rocha, L. M. Garbers, S. Kusma, Fernando Borge Teixeira, E. Vialle, L. Vialle
ABSTRACT Objective: To compare pharmacological and non-pharmacological prophylaxis in elective spine surgery to determine the risks of DVT, PTE, and epidural hematoma (EH) in both groups, as well as their respective treatment effectiveness. Methods: Systematic review and meta-analysis based on systematically searched articles, using combinations of MeSH terms related to chemoprophylaxis and non-chemoprophylaxis for prevention of deep vein thrombosis and pulmonary embolism in elective spine surgery. Adult patients were eligible for inclusion in the study, except for those with trauma, spinal cord injury, neoplasms, or those using vena cava filters. Results: Five studies were selected for this systematic review and meta-analysis: 3 retrospective studies, 1 prospective study, and 1 case series. Data analysis showed that 4.64% of patients treated with chemoprophylaxis had an unfavorable outcome regarding DVT, while this outcome occurred in 1.14% of patients not treated with chemoprophylaxis (p=0.001). Among patients using chemoprophylaxis, only 0.1% developed epidural hematoma and 0.38% developed PTE. Among those on non-pharmaceutical prophylaxis, 0.04% had EH (p=0.11) and 0.42% had PTE (p=0.45). Conclusions: No benefits were found for chemoprophylaxis as compared to non-chemoprophylaxis in preventing DVT in elective spine surgery, nor was there an increased risk of epidural hematoma or fatal thromboembolic events. Level of evidence III; Therapeutic studies; Investigation of treatment results.
{"title":"THE USE OF CHEMOPROPHYLAXIS OR NOT FOR DVT IN SPINE SURGERY: A SYSTEMATIC REVIEW","authors":"Bruno Landal Cavassin, Carolina Cabral Brandalizze, Gabriel Wielisvky Rocha, L. M. Garbers, S. Kusma, Fernando Borge Teixeira, E. Vialle, L. Vialle","doi":"10.1590/s1808-185120222102258863","DOIUrl":"https://doi.org/10.1590/s1808-185120222102258863","url":null,"abstract":"ABSTRACT Objective: To compare pharmacological and non-pharmacological prophylaxis in elective spine surgery to determine the risks of DVT, PTE, and epidural hematoma (EH) in both groups, as well as their respective treatment effectiveness. Methods: Systematic review and meta-analysis based on systematically searched articles, using combinations of MeSH terms related to chemoprophylaxis and non-chemoprophylaxis for prevention of deep vein thrombosis and pulmonary embolism in elective spine surgery. Adult patients were eligible for inclusion in the study, except for those with trauma, spinal cord injury, neoplasms, or those using vena cava filters. Results: Five studies were selected for this systematic review and meta-analysis: 3 retrospective studies, 1 prospective study, and 1 case series. Data analysis showed that 4.64% of patients treated with chemoprophylaxis had an unfavorable outcome regarding DVT, while this outcome occurred in 1.14% of patients not treated with chemoprophylaxis (p=0.001). Among patients using chemoprophylaxis, only 0.1% developed epidural hematoma and 0.38% developed PTE. Among those on non-pharmaceutical prophylaxis, 0.04% had EH (p=0.11) and 0.42% had PTE (p=0.45). Conclusions: No benefits were found for chemoprophylaxis as compared to non-chemoprophylaxis in preventing DVT in elective spine surgery, nor was there an increased risk of epidural hematoma or fatal thromboembolic events. Level of evidence III; Therapeutic studies; Investigation of treatment results.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479186","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/s1808-185120222102260083
D. Giubilei, D. Santos, Monres Jose Gomes, Marcio Oliveira Penna de Carvalho
ABSTRACT This paper describes the technique of interlaminar endoscopic surgery guided by a portable ultrasound device. This innovation allows endoscopic surgery to be performed without the use of real-time radiography, which is associated with a higher risk of radiation damage. The portable wireless ultrasound device used for this technique, which has not been yet described in the world literature for minimally invasive surgeries, can be used as an imaging tool to delimit the interlaminar space in minimally invasive surgeries via both transverse and sagittal views. Level of evidence I; Quality of evidence A.
{"title":"ENDOSCOPIC INTERLAMINAR SPINE SURGERY GUIDED BY PORTABLE ULTRASOUND: A NEW TECHNIQUE","authors":"D. Giubilei, D. Santos, Monres Jose Gomes, Marcio Oliveira Penna de Carvalho","doi":"10.1590/s1808-185120222102260083","DOIUrl":"https://doi.org/10.1590/s1808-185120222102260083","url":null,"abstract":"ABSTRACT This paper describes the technique of interlaminar endoscopic surgery guided by a portable ultrasound device. This innovation allows endoscopic surgery to be performed without the use of real-time radiography, which is associated with a higher risk of radiation damage. The portable wireless ultrasound device used for this technique, which has not been yet described in the world literature for minimally invasive surgeries, can be used as an imaging tool to delimit the interlaminar space in minimally invasive surgeries via both transverse and sagittal views. Level of evidence I; Quality of evidence A.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479192","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/s1808-185120222102262474
Felipe Ramalho Guedes, Fernanda Andrea Minutti Navarro, Rodrigo Yuiti Nakao, I. Franco, L. Rodrigues
ABSTRACT Objective: To evaluate the prevalence of low back pain in nurses at a university hospital in São Paulo and establish a relationship with social aspects. Methods: A cross-sectional study was carried out, through the application of a questionnaire containing social questions(weight, age, height, work sector, working hours, physical activity, presence and frequency of low back pain) in addition to the Oswestry questionnaire. Results: One hundred fifty-three nurses participated in the study. Of these, 92.30% of the women and 73.91% of the men presented low back pain, with a third classifying the pain as sporadic. In relation to BMI, pain is lower in those who are underweight (60%) and higher among those who are overweight (96.77%). Most of the sample was sedentary (66%), and of these, 96% had low back pain. There was no difference in the comparison by working hours, in relation to work sector, pain was more present in the following sectors: coordination (100%); children’s ward (92%); adult emergency room (90%) and adult ICU (31%). Thirty nurses worked double shifts, and of these, 90% reported low back pain, while among those who worked only at the university hospital, 89.4% reported pain. In relation to working hours, the longer the working day, the greater the pain. In the function assessment (Oswestry), 99 participants obtained a value of up to 30% disability. Conclusion: Based on the results of this work, it is concluded that there is a high prevalence of low back pain in nurses at the Hospital Universitário; however, it was not possible to determine a direct risk factor associated with this high prevalence. Level of Evidence IV; Cross-sectional study.
{"title":"THE PREVALENCE OF LOW BACK PAIN IN NURSES AT A UNIVERSITY HOSPITAL IN THE EASTERN AREA OF SÃO PAULO","authors":"Felipe Ramalho Guedes, Fernanda Andrea Minutti Navarro, Rodrigo Yuiti Nakao, I. Franco, L. Rodrigues","doi":"10.1590/s1808-185120222102262474","DOIUrl":"https://doi.org/10.1590/s1808-185120222102262474","url":null,"abstract":"ABSTRACT Objective: To evaluate the prevalence of low back pain in nurses at a university hospital in São Paulo and establish a relationship with social aspects. Methods: A cross-sectional study was carried out, through the application of a questionnaire containing social questions(weight, age, height, work sector, working hours, physical activity, presence and frequency of low back pain) in addition to the Oswestry questionnaire. Results: One hundred fifty-three nurses participated in the study. Of these, 92.30% of the women and 73.91% of the men presented low back pain, with a third classifying the pain as sporadic. In relation to BMI, pain is lower in those who are underweight (60%) and higher among those who are overweight (96.77%). Most of the sample was sedentary (66%), and of these, 96% had low back pain. There was no difference in the comparison by working hours, in relation to work sector, pain was more present in the following sectors: coordination (100%); children’s ward (92%); adult emergency room (90%) and adult ICU (31%). Thirty nurses worked double shifts, and of these, 90% reported low back pain, while among those who worked only at the university hospital, 89.4% reported pain. In relation to working hours, the longer the working day, the greater the pain. In the function assessment (Oswestry), 99 participants obtained a value of up to 30% disability. Conclusion: Based on the results of this work, it is concluded that there is a high prevalence of low back pain in nurses at the Hospital Universitário; however, it was not possible to determine a direct risk factor associated with this high prevalence. Level of Evidence IV; Cross-sectional study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479270","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/s1808-185120222103147809
Marcus Vinicius Brito Marques, Sylvio Mistro Neto, Roberto Rossanez, P. Cavali, A. Rossato, Elcio Landim, Marcelo ítalo Risso Neto
ABSTRACT Objective: To evaluate the intra- and inter-observer reproducibility of the evaluation of the pelvic obliquity (PO) in patients with neuro-muscular deformities via the method that uses the iliac crests and the method that uses the upper endplate of S1 and to determine whe ther there is a relationship between the methods. Methods: The digitized panoramic radiographies of thirty patients with cerebral paralysis or myelomeningocelein outpatient monitoring were evaluated by four examiners: two experienced spinal surgeons and two fellows. Two radiographs were excluded because analysis was impossible. All exams were obtained in accordance with the periodic monitoring protocol in the sitting position, using digitized film and a film-focus distance of 110 cm Results: High intra- and inter-observer agreement was observed both for method that uses the iliac crests and the method that evaluates the S1 endplate. However, no significant relationship between the two methods was observed. Conclusions: The methods evaluated had good reproducibility and agreement among the observers. It was confirmed that, on account of the existent linear relation, it is possible to estimate the value of the iliac crest method knowing the value obtained by the S1 plateau multiplied by 0.76. There was no agreement between the iliac crest and S1 plateau PO evaluation methods. Level of evidence IV; Retrospective cross-sectional study.
{"title":"COMPARISON BETWEEN TWO METHODS OF MEASURING PELVIC OBLIQUITY IN CEREBRAL PALSY AND MYELOMENINGOCELE","authors":"Marcus Vinicius Brito Marques, Sylvio Mistro Neto, Roberto Rossanez, P. Cavali, A. Rossato, Elcio Landim, Marcelo ítalo Risso Neto","doi":"10.1590/s1808-185120222103147809","DOIUrl":"https://doi.org/10.1590/s1808-185120222103147809","url":null,"abstract":"ABSTRACT Objective: To evaluate the intra- and inter-observer reproducibility of the evaluation of the pelvic obliquity (PO) in patients with neuro-muscular deformities via the method that uses the iliac crests and the method that uses the upper endplate of S1 and to determine whe ther there is a relationship between the methods. Methods: The digitized panoramic radiographies of thirty patients with cerebral paralysis or myelomeningocelein outpatient monitoring were evaluated by four examiners: two experienced spinal surgeons and two fellows. Two radiographs were excluded because analysis was impossible. All exams were obtained in accordance with the periodic monitoring protocol in the sitting position, using digitized film and a film-focus distance of 110 cm Results: High intra- and inter-observer agreement was observed both for method that uses the iliac crests and the method that evaluates the S1 endplate. However, no significant relationship between the two methods was observed. Conclusions: The methods evaluated had good reproducibility and agreement among the observers. It was confirmed that, on account of the existent linear relation, it is possible to estimate the value of the iliac crest method knowing the value obtained by the S1 plateau multiplied by 0.76. There was no agreement between the iliac crest and S1 plateau PO evaluation methods. Level of evidence IV; Retrospective cross-sectional study.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479314","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/s1808-185120222103265129
E. A. Iunes, F. Onishi, H. R. D. Costa, Thiago Leonardi Azuaga
ABSTRACT Spinal cord injuries can have serious consequences for the individual, such as loss of motor function, sensory impairment, and alteration of physiological systems functions. Treatments for spinal cord injuries involve the use of drugs and surgical approaches. In the surgical field, there is a question about the ideal time after the trauma to perform the surgical procedure. The studies divide the time until surgery after the injury into two categories: “early” and “late”. To review the scientific literature on this topic, and to assess the relative effectiveness of early versus late decompressive surgery, we considered early intervention up to 24 hours and late intervention from 24 hours after the injury. For this, we performed a literature review and selected retrospective, prospective observational studies, clinical studies, and reviews with meta-analysis that compared the recovery time of patients with spinal cord injury after surgeries performed within 24 hours (early) and after 24 hours (late). The results showed potential for neurological improvement with early or even ultra-early surgical decompression (up to 12 hours) in patients with traumatic cervical spinal cord injury. On the other hand, reports about the advantage of early decompression when there is a thoracic injury are scarce. In addition to the time to decompression, the concomitant use of some drugs seems to play an important role in patients’ recovery. Level of Evidence II; Literature review.
{"title":"EFFECT OF TIME UNTIL DECOMPRESSION ON NEUROLOGIC RECOVERY AFTER SPINAL CORD INJURY","authors":"E. A. Iunes, F. Onishi, H. R. D. Costa, Thiago Leonardi Azuaga","doi":"10.1590/s1808-185120222103265129","DOIUrl":"https://doi.org/10.1590/s1808-185120222103265129","url":null,"abstract":"ABSTRACT Spinal cord injuries can have serious consequences for the individual, such as loss of motor function, sensory impairment, and alteration of physiological systems functions. Treatments for spinal cord injuries involve the use of drugs and surgical approaches. In the surgical field, there is a question about the ideal time after the trauma to perform the surgical procedure. The studies divide the time until surgery after the injury into two categories: “early” and “late”. To review the scientific literature on this topic, and to assess the relative effectiveness of early versus late decompressive surgery, we considered early intervention up to 24 hours and late intervention from 24 hours after the injury. For this, we performed a literature review and selected retrospective, prospective observational studies, clinical studies, and reviews with meta-analysis that compared the recovery time of patients with spinal cord injury after surgeries performed within 24 hours (early) and after 24 hours (late). The results showed potential for neurological improvement with early or even ultra-early surgical decompression (up to 12 hours) in patients with traumatic cervical spinal cord injury. On the other hand, reports about the advantage of early decompression when there is a thoracic injury are scarce. In addition to the time to decompression, the concomitant use of some drugs seems to play an important role in patients’ recovery. Level of Evidence II; Literature review.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67479961","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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