Navegando por Palavras-chave "Coluna vertebral"

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    Ardrodese da coluna lombossacra com fixação metálica e enxerto ósseo: estudo baseado em 40 casos utilizando o implante A-Systems
    (Universidade Federal de São Paulo (UNIFESP), 1998) Serdeira, Afrane [UNIFESP]; Barros Filho, Tarcisio Eloy Pessoa de [UNIFESP]
    Foram avaliados 40 pacientes com espondilolistese e instabilidade lombossacra: 13 pacientes do tipo istmica-litica, 19 do tipo degenerativa, 2 pacientes do tipo traumatica, l tipo do patologica, e 5 do tipo cirurgica nos quais foram realizadas 40 artrodeses da coluna lombossacra com enxerto osseo e fixacao metalica com o implante A-Systems. A avaliacao dos pacientes foi realizada clinica e radiograficamente, nos periodos pre-operatorio, pos-operatorio imediato e pos-operatorio tardio. O tempo de acompanhamento clinico maximo foi de 46 meses, o minimo de 1O meses, obtendo-se um acompanhamento medio de 11 meses. Ocorreram 11 complicacoes: 2 pacientes (5 por cento ) com pseudartrose; 2 pacientes (5 por cento ) com retardo de consolidacao do enxerto; 4 pacientes (lO por cento ) com dor na area doadora de enxerto; l paciente (2,5 por cento ) nao teve alivio da dor lombar l paciente (2,5 por cento ) apresentou dor transitoria e l paciente (2,5 por cento ) apresentou escara infectada na regiao sacra. A avaliacao global tanto do ponto vista do paciente como da equipe medica mostrou que 36 (90 por cento ) dos pacientes obtiveram bom resultado, tres pacientes (7,5 por cento ) apresentaram melhora em relacao ao pre-operatorio e um paciente (2,5 por cento ) nao obteve melhora. Vinte e nove pacientes (72,5 por cento ) tiveram sua capacidade de trabalho normalizada, nove (22,5 por cento ) pacientes tiveram sua capacidade melhorada em 75 por cento e dois (5 por cento ) pacientes tiveram a capacidade melhorada em 50 por cento . Vinte e um pacientes (52,5 por cento ) tiveram o indice de Prolo aumentado entre 9 e l O (excelente); 14 (35 por cento ) tiveram indice de Prolo aumentado para 7 e 8 (bom); em 5 (l2,5 por cento ) o indice ficou entre 5 e 6 (regular) e nenhum paciente teve indice 2, 3 ou 4 (mau). O tempo medio de retorno para as atividades normais variou de tres a doze meses, com uma media de sete meses. Em comparacao com metodos similares relatados pela literatura, o implante mostrou-se tao eficiente quanto eles, com as vantagens da 78 simplicidade, da possibilidade de ser usado em varios niveis e da rigidez apos montado
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    Artrodese da coluna lombossacra com o implante A-Systems
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2004-12-01) Serdeira, Afrane; Barros Filho, Tarcísio Eloy Pessoa de; Puertas, Eduardo Barros [UNIFESP]; Laredo Filho, José [UNIFESP]; Di Mare Arbo, Rodrigo; Glass, Alexandre M.; Pontíficia Universidade Católica do Rio Grande do Sul Hospital São Lucas Serviço de Ortopedia e Traumatologia; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Lumbosacral column arthrodesis with bone graft and metallic fixation (A-Systems implant) was carried out in 40 patients with spondylolisthesis and lumbosacral instability of the following types: isthmic-lytic in 13, degenerative in 19, traumatic in 2, pathological in 1, and surgical in 5. Preoperative, immediate postoperative, and late postoperative clinical and radiological evaluation was carried out. Clinical follow-up ranged from 10 to 46 months (mean follow-up: 11 months). Patient's and Physician's overall evaluation showed the following results: good results in 36 (39%) patients; improvement as compared to preoperative condition in 3 (7.5%); unchanged condition in 1 (2.5%); normalized labor capability in 29 (72.5%) patients; improvement of 75% in labor capability in 9 (22.5%) patients; and improvement of 50% in 2 (5%) patients. As for the Prolo rate, an increase to 9-10 (excellent) was seen in 21 (52.5%) patients; an increase to 7 and 8 (good) was seen in 14 (35%); an increase to 5 to 6 (moderate) was found in 5 (12.5%) patients. No patient had a Prolo rate of 2, 3, or 4 (poor). Mean time until return to normal activities ranged from 3 to 12 months (mean: 7 months). As compared to similar methods reported in literature, the implant has been shown to be equaally effective, with the following advantages: simplicity, use at different levels; rigidity following assembly.
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    Avaliação clínica, radiológica e tomográfica da relação sacral em pacientes portadores de anomalia anorretal como indicador de malformações da coluna lombossacra e da continência fecal
    (Universidade Federal de São Paulo (UNIFESP), 2002) Macedo, Mauricio [UNIFESP]; Martins, José Luiz [UNIFESP]
    Objetivo: Avaliar a relacao sacral de pacientes portadores de anomalia anorretal, visando verificar se e uma indicadora precisa do grau de malformacao da coluna lombossacra e do prognostico funcional desses pacientes, quanto a continencia fecal. Metodos: Foram analisados os dados clinicos, radiologicos e tomograficos de 54 pacientes portadores de anomalia anorretal. A relacao sacral de cada paciente foi correlacionada com os dados clinicos de continencia fecal e com a presenca ou nao de malformacoes da coluna lombossacra. Resultados: Foram observados tres padroes de coluna lombossacra nos pacientes analisados, quais sejam, normal, falha de fusao de arco posterior e agenesia de sacro. A relacao sacra[ nao apresentou diferenca estatisticamente significante entre o grupo dos normais e o grupo dos portadores de falha de fusao de arco posterior, ao contrario do que se observou entre o grupo dos normais e o grupo dos portadores de agenesia de sacro. A continencia fecal esteve diretamente relacionada com a presenca ou nao de malformacao da coluna lombossacra, porem nao apresentou correlacao com o valor da relacao sacral. Conclusoes: 1-A relacao sacral nao e um indicador preciso do grau de malformacao da coluna lombossacra nos pacientes portadores de anomalia anorretal 2- A relacao sacral e um indicador preciso do grau de malformacao da coluna lombossacra somente nos portadores de agenesia de sacro. 3- A relacao sacral nao se apresentou como um bom indice de prognostico funcional, quanto a continencia fecal
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    Comparação dos efeitos da estimulação elétrica nervosa transcutânea em pacientes com lombalgia crônica não específica: ensaio clínico randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2007) Facci, Ligia Maria [UNIFESP]; Trevisani, Virgínia Fernandes Moça [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: Os equipamentos de eletroterapia mais utilizados no tratamento da lombalgia crônica não-específica são a Estimulação Elétrica Nervosa Transcutânea (TENS) e a Corrente Interferencial (CI). Ainda são escassas, porém, as evidências que justifiquem a sua utilização na prática clínica. Objetivos: O objetivo deste estudo foi comparar os efeitos da Estimulação Elétrica Transcutânea (TENS) com os da Corrente Interferencial (CI) em pacientes com lombalgia crônica não-específica. Métodos: Cento e cinqüenta pacientes com lombalgia crônica não-específica foram randomicamente divididos em três grupos: 1)TENS; 2) Corrente Interferencial e 3) Controle. Os pacientes designados à eletroterapia receberam 10 sessões de 30 minutos, em dias consecutivos, enquanto os pacientes do grupo controle permaneceram sem tratamento pelo mesmo período.Todos os pacientes foram avaliados, antes e depois do protocolo de tratamento, quanto à intensidade de dor através da EVA e do Questionário McGill; capacidade funcional, pelo questionário Roland-Morris; e utilização de medicamentos adicionais ao tratamento. Resultados: Cento e trinta e sete pacientes completaram o protocolo de tratamento, sendo 72,7 por cento do sexo feminino e 27,3 por cento do masculino, com média de idade de 47,16 ± 15,93 anos. Com relação à intensidade de dor, houve redução média na EVA de 44,86 mm (IC:- 52,4; -35,6) no grupo 2, de 39,18 mm (IC: -48,7; -29,7) no grupo 1, e de 8,53 mm (IC:-15,7; -01,3) no grupo 3, e no questionário McGill a redução do PPI no grupo 1 foi mais evidente, e do PRI e do NWC no grupo 2. No questionário Roland Morris, o grupo 2 teve redução média de 7,20, o grupo 1 de 6,59 e o grupo 3 de 0,70 pontos. É importante destacar que 84 por cento dos pacientes do grupo 1, 75 por cento do grupo 2 e 34 por cento do grupo 3 deixaram de tomar o medicamento após tratamento. Em todos os desfechos investigados, o grupo Controle apresentou diferença estatisticamente significante com relação aos demais grupos (p<0,0001), mas, apesar dos pacientes que receberam CI terem obtido melhores resultados na redução da dor e na melhora da capacidade funcional, estes não foram estatisticamente significantes quando comparados ao grupo de TENS (p>0,05). Conclusão: No tratamento da lombalgia crônica não-específica, tanto a TENS como Corrente Interferencial melhoram a capacidade funcional, reduzem a dor e diminuem a utilização de medicamentos quando comparados ao controle. Não há diferença, entretanto, entre os efeitos dos dois equipamentos de eletroterapia..
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    Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar
    (Sociedade Brasileira de Coluna, 2010-12-01) Leite, Marcio Squassoni [UNIFESP]; Luciano, Rafael Paiva [UNIFESP]; Martins, Délio Eulálio [UNIFESP]; Wajchenberg, Marcelo [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: to correlate the changes found in the lumbar magnetic resonance imaging according to Modic and Pfirrmann classifications. METHODS: lumbar spine resonances of 54 outpatients were selected (23 men and 31 women), who were already under investigation because of their comorbidity. According to their degree of Pfirrmann classification, 264 intervertebral discs (L1 to S1) were classified. The presence of signal abnormalities of the vertebral body was recorded as Modic classification. The χ2 mwas applied, adopting significance levels below 0.05 (a=5%). RESULTS: The mean age studied was of 48.4 years (26-77 years). A higher prevalence of Pfirrmann type IV (31.1%) was observed. In 88.3% of the sample, Modic was absent, and also Modic 3; 60% of Modic 2 was related to Pfirrmann type V, and 36.4% of Modic 1 was equally distributed among Pfirrmann type IV and V. Statistically significant association between Modic changes and Pfirrmann (p<0.001) was found. CONCLUSION: there was a clear association between the classifications studied, comparing the stages of Pfirrmann (IV and V) with Modic type 1 and 2.
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    Correlação entre o posicionamento dos parafusos pediculares no corpo vertebral e sua força de arrancamento
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2008-01-01) Rodrigues, Luciano Miller Reis; Fujiki, Edison Noburu.; Yonezaki, Adriano Masayuki; Puertas, Eduardo Barros [UNIFESP]; Wajchenberg, Marcelo [UNIFESP]; Milani, Carlo [UNIFESP]; Faculdade de Medicina do ABC; Universidade Federal de São Paulo (UNIFESP)
    The objective of this paper was to study pedicular screws fixation strength on vertebral bodies by varying its repositioning angle. For this Study, eight pigs were selected, making up a total of 40 lumbar vertebrae, which were divided into 4 study groups. In the first group, the screws were inserted at zero degree, and in the second group, they were inserted and reinserted at the same position, while in the third group, the screws were reinserted within a 14-degree range, and, in the fourth group, within a 28-degree range. All screws were tested for pullout strength. Group I presented a pullout average of 146.85N. Group II presented a pullout average of 77.34N. Group III had an average of 97.75N. Group IV had an average of 110.02. It was concluded that the procedure of replacing screws should be avoided. Should any repositioning is required, this should be performed by changing repositioning angles as much far from the first one as possible.
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    Correlations between radiographic, magnetic resonance and histological examinations on the degeneration of human lumbar intervertebral discs
    (Associação Paulista de Medicina - APM, 2010-01-01) Martins, Delio Eulalio [UNIFESP]; Oliveira, Valdeci Manoel de; Alves, Maria Teresa de Seixas [UNIFESP]; Wajchenberg, Marcelo [UNIFESP]; Landim, Élcio; Belloti, Joao Carlos [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Ishida, Akira [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade de Ciências Médicas e da Saúde de Juiz de Fora; Universidade Federal Juiz de Fora School of Medicine; Santa Casa de São Paulo Faculdade de Ciências Médicas Department of Orthopedics and Traumatology; Associação de Assistência à Criança Deficiente
    CONTEXT AND OBJECTIVE: There is controversy regarding which imaging method is best for identifying early degenerative alterations in intervertebral discs. No correlations between such methods and histological finds are presented in the literature. The aim of this study was to correlate the thickness of intervertebral discs measured on simple radiographs with the degree of degeneration seen on magnetic resonance images and the histological findings relating to nerve ends inside the discs. DESIGN AND SETTING: Cross-sectional correlation study on the lumbar spines of human cadavers, at Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil. METHODS: Ten lumbar spinal columns were extracted from human cadavers and subjected to magnetic resonance imaging and simple radiography. They were classified according to the degree of disc degeneration seen on magnetic resonance, and the thickness of the discs was measured on radiographs. The intervertebral discs were then extracted, embedded in paraffin and analyzed immunohistochemically with protein S100, and the nerve fibers were counted and classified. RESULTS: No correlation was observed between the thickness of the intervertebral discs and the degree of degeneration seen on magnetic resonance images. Only the uppermost lumbar discs (L1/L2 and L2/L3) presented a correlation between their thickness and type I and IV nerve endings. CONCLUSION: Reduced disc thickness is unrelated to increased presence of nerve ends in intervertebral discs, or to the degree of disc degeneration.
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    Descompressão neural isolada ou associada à fusão póstero-lateral nas afecções degenerativas lombossacras: avaliação da qualidade de vida e incapacidade funcional pós-operatória
    (Sociedade Brasileira de Coluna, 2012-01-01) Gotfryd, Alberto Ofenhejm; Spolidoro, Douglas Romano; Poletto, Patrícia Rios [UNIFESP]; Santa Casa da Misericórdia de Santos Departamento de Ortopedia e Traumatologia Grupo de Coluna Vertebral; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To compare the quality of life, pain and satisfaction of patients undergoing lumbar isolated decompression neural to those who had posterolateral fusion associated. METHODS: The study enrolled 44 subjects with lumbar herniated discs and/or degenerative central or foraminal stenosis treated surgically. Patients were divided into two groups: decompression (D) and decompression and fusion (DF). The criteria used to define the need for arthrodesis was the presence of deformity or segmental instability, measured by plain and dynamic radiographs. The patients completed questionnaires regarding postoperative follow-up (use of analgesic medications and satisfaction with the treatment) and visual analog scale for lumbar pain and sciatica. Moreover, the questionnaires Oswestry and SF-36 were administered to assess quality of life. RESULTS: We found excellent results in the Oswestry questionnaire, good levels for the domains Pain and functional capacity in the SF-36, and low intensity of back pain and sciatica in both groups analyzed, without statistically significant differences between them. CONCLUSIONS: We found no differences in the quality of life, pain and satisfaction in patients undergoing lumbar nerve decompression alone compared to those who had associated fusion, using as a criterion for arthrodesis the presence of deformities and/orsegmental instability.
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    Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial
    (Associação Paulista de Medicina - APM, 2011-01-01) Facci, Ligia Maria [UNIFESP]; Nowotny, Jean Paulus; Tormem, Fabio; Trevisani, Virgínia Fernandes Moça [UNIFESP]; Centro Universitário de Maringá; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) and interferential current are the most used electrotherapy methods, although there is little scientific evidence to support their use. The aim of this study was to compare the effects of TENS and interferential current among patients with nonspecific chronic low back pain. DESIGN AND SETTING: Single-blind randomized controlled trial in the Department of Physiotherapy, Centro Universitário de Maringá. METHODS: One hundred and fifty patients were randomly divided into three groups: TENS (group 1), interferential current (group 2) and controls (group 3). The patients designated for electrotherapy received ten 30-minute sessions, while the control group remained untreated. All patients and controls were evaluated before and after treatment using a visual analog scale and the McGill Pain and Roland Morris questionnaires, and regarding their use of additional medications. RESULTS: There was a mean reduction on the visual analog scale of 39.18 mm with TENS, 44.86 mm with interferential current and 8.53 mm among the controls. In the Roland Morris questionnaire, group 1 had a mean reduction of 6.59; group 2, 7.20; and group 3, 0.70 points. In group 1, 84% of the patients stopped using medications after the treatment; in group 2, 75%; and in group 3, 34%. There was no statistically significant difference between the TENS and interferential current groups (P > 0.05); a difference was only found between these groups and the controls (P < 0.0001). CONCLUSION: There was no difference between TENS and interferential current for chronic low back pain treatment. CLINICAL TRIAL REGISTRATION: NCT01017913.
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    Espondilólise e espondilolistese em ginastas jovens
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2010-01-01) Mohriak, Rafael [UNIFESP]; Debieux, Pedro [UNIFESP]; Trandafilov Junior, Miguel [UNIFESP]; Martins, Délio Eulálio [UNIFESP]; Wajchenberg, Marcelo [UNIFESP]; Cohen, Moises [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To determine the incidence of spondylolysis and spondylolisthesis in young, female gymnasts, and to correlate these with lumbar pain, history of trauma and training load. METHOD: A total of 18 would-be Olympic gymnasts, aged 8-17, with an average age of 11.3, were voluntarily evaluated. The Gymnasts were asked to complete a questionnaire about their sports activities, and were submitted to a clinical examination and lumbar spine radiography. RESULTS: The radiographies were analyzed by experienced specialists in surgery of the vertebral column, who found a 5.56% incidence of spondylolysis and no cases of spondylolisthesis. CONCLUSION: The incidence of radiographic alterations identified remained close to those reported in the literature for non-athletic individuals, and the lumbalgia indicated by the athletes showed no direct relation with spondylolysis and spondylolisthesis.
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    Estudo comparativo do arco de movimento da coluna lombar em indivíduos praticantes e não praticantes de esporte
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2010-01-01) Chertman, Carla [UNIFESP]; Santos, Humberto Maldonado Campoy Dos [UNIFESP]; Pires, Leonardo [UNIFESP]; Wajchenberg, Marcelo [UNIFESP]; Martins, Delio Eulálio [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJETIVE: To compare the amplitude of trunk flexion and extension through goniometry in athletes and non-athletes, relating these data to popliteal angle and ischiotibial tests. METHODS: The amplitude of trunk flexibility and extension was evaluated in 50 individuals who practiced sports on a regular basis and 50 non-athletes who did not report painful symptomatology nor any symptom that could affect test performance. The measurements were made consecutively by two independent examiners by means of goniometry. The trunk flexibility and extension results were correlated to the popliteal angle and ischiotibial test, and the statistical correlation between them was analyzed. RESULTS: The average values obtained were 130.7 (101.9) for flexion and 40.2 (36.4) for extension. A significant statistical difference between the athletes and non-athletes was found in the following parameters: goniometer in flexion with examiner 1, goniometer in flexion with examiner 2 and ischiotibial test. No significant statistical differences have been found between the groups or in relation to the following parameters: goniometer in extension with examiner 1, goniometer in extension with examiner 2 and popliteal angle. CONCLUSION: Individuals who practice sports present higher values in trunk flexion than non-athletes. The use of goniometry to measure trunk amplitude showed variable measurements between examiners.
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    Estudo comparativo dos mecanorreceptores dos discos intervertebrais normais e degenerados da coluna lombar de humanos pela radiografia, ressonância magnética e estudo anatomopatológico
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2007-01-01) Oliveira, Valdeci Manoel de [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Alves, Maria Teresa de Seixas [UNIFESP]; Yamashita, Helio Kiitiro [UNIFESP]; Faculdade de Ciências Médicas e da Saúde de Juiz de Fora; UFJF Faculdade de Medicina; Universidade Federal de São Paulo (UNIFESP)
    The authors conducted a study on human lumbar spine, aiming to assess and determine the different kinds of nervous fibers in normal and degenerated intervertebral discs. Ten cadaver s lumbar spines with approximately 48 - 72 of death have been used. The pieces were submitted to simple X-ray and magnetic resonance tests. Subsequently to the tests, discs were divided into normal and degenerated. Then, they were dissected, divided into anterior and posterior according to the region, included in paraffin and an immunohistochemical study with S100 protein was performed. With the aid of Image-Pro Plus computer software (media cybernetics) ®, nervous fibers diameters were measured as micrometers and classified into four kinds of fibers. Four types of nervous fibers were found on different disc regions. The number and kind of fibers varied according to the region and degree of intervertebral disc degeneration. It was concluded that type-III fibers are more common at the anterior region; type-II and type-IV fibers are more common at the posterior region, and type-I fibers do not show any differences regarding anterior and posterior regions; in addition, a degenerated disc has a higher number of nervous fibers than a normal one.
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    Estudo mecânico de implante para fixação do segmento lombossacro da coluna vertebral
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2000-09-01) Serdeira, Afrane [UNIFESP]; Barros Fº, Tarcísio Eloy Pessoa de; Puertas, Eduardo Barros [UNIFESP]; Laredo Filho, José [UNIFESP]; Leivas, Tomaz Puga; Universidade Federal de São Paulo (UNIFESP); PUCRS Hospital São Lucas Serviço de Ortopedia e Traumatologia; Universidade de São Paulo (USP)
    This work consists of a mechanical analysis of the resistance and critical points of a stainless steel device for lumbossacral spinal fixation. The device was fixed into a wooden model representing the spinal lumbossacral segment. The experiment comprised seven tests of flexo-compression, seven tests of axial rigidity, seven tests of radial rigidity, and one destructive test. The critical points are the intersection of the pedicular screws threads and the attrition rate between the vise and the rod. The results demonstrated the device to be efficient and safe when used in human beings.
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    Influência da extensão da artrodese lombossacra nos resultados clínicos e funcionais
    (Sociedade Brasileira de Coluna, 2012-01-01) Gotfryd, Alberto Ofenhejm; Henriques, Guilherme Galito; Poletto, Patrícia Rios [UNIFESP]; Santa Casa da Misericórdia de Santos Departamento de Ortopedia e Traumatologia Grupo de Coluna Vertebral; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: Investigate the influence of the extent of posterolateral lumbosacral fusion and its impact on clinical and functional results. METHODS: We evaluated 22 patients with central or foraminal stenosis or lumbar disc herniation associated with segmental instability that underwent to surgery for nerve decompression and posterolateral arthrodesis. Patients were divided into two groups according to the number of levels fused: Group 1: fusion at one level and Group 2: fusion of two or more levels. Patients completed questionnaires regarding postoperative follow-up (use of analgesic medications and treatment satisfaction) and visual analog scale for lumbar pain and sciatica. Moreover, the questionnaires Oswestry and SF-36 were administered to assess quality of life. RESULTS: SF-36 showed good levels of quality of life in both groups, except the field Physical Aspects. There was no significant correlation between the extent of the arthrodesis and clinical outcomes. CONCLUSIONS: Patients who underwent posterolateral arthrodesis showed satisfactory quality of life, except for a decrease of physical fitness. However, the higher number of levels fused did not have negative impact on clinical and functional aspects.
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    Influência do ângulo da bacia e do ângulo de Cobb sobre o padrão da marcha em mulheres acima de 60 anos
    (Universidade Federal de São Paulo (UNIFESP), 2018-09-05) Oliveira, Leda Magalhaes de [UNIFESP]; Roizenblatt, Suely Steinschreiber [UNIFESP]; http://lattes.cnpq.br/3666475159211385; Universidade Federal de São Paulo (UNIFESP)
    Introduction: the dynamics of the head, arms and back is vital for maintaining, balance during gait with advancing age. Hyperkyphosis, common in the elderly requires compensations for maintaining balance and, consequently, alter the quality of posture and gait, increasing the risk of falls. Objectives: primary objective: to determine the participation of the pelvic and the vertebral column angles in gait and balance parameters in women over 60 years of age. Secondary objective: to evaluate the relationships of the pelvic and the vertebral column angles with clinical tests for gait and balance. Methods: this is a transversal study of elderly women without gait dysfunction and preserved cognition (MiniMental - MMSE> 24. Berg Scale (BS), timed up and go (TUG), comfortable and fast walk in 10 m, and fall questionnaire were used. The sagittal radiological evaluation was performed for Thoracic Cobb (TC) and Lumbar (LC), Pelvic Incidence (PI), Sacral Inclination (SI) and Pelvic Inclination (PeI). The gait evaluation was assessed by accelerometry in a 30-meter walk and the parameters evaluated were: step length, Root Mean Square (RMS ) of acceleration during walking, symmetry, step and regularity of the stride in the anteroposterior (AP) and vertical (V) planes. Results: fifty-five elderly women with a mean age of 72 years (SD=6) were recruited. FES-I-Brazil was 25.2 (6.6); BS 49.4 (3.8); TUG 9.9 (2.2) seconds; Comfortable walking 1.09 (0.19) m/s, fast walking 1.38 (0.24) m/s. The radiographic angles were: TC 52 (15°), LC 55 (17°), PI 57 (11°), SI 39 (11°) and PeI 17 (8°). Correlations of BS with IS (0,377) and PeI with 10m of fast walk (0.366); LC with SI angles (0.637) and PeI with SI (0.674) were observed. Regarding accelerometry, SI was associated with step length (p = 0.082) and symmetry (p<0.001) and step regularity (p <0.001) in the AP plane. Association was found between LC and RMS in the V plane (p = 0.076), stride regularity in AP (p = 0.016) and regularity of the V-step (p = 0.02). In addition, TC was associated with stride regularity (p = 0.026), step regularity (0.026); symmetry in the AP plane (0.034) and stride regularity in V plane (p = 0.01). Conclusion: In elderly women with preservation of functional capacity the angles of the spine and pelvis interfere with gait quality, particularly in the anteroposterior plane.
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    Influência do músculo diafragma na coluna vertebral de crianças respiradoras bucais
    (Universidade Federal de São Paulo (UNIFESP), 2006) Yi, Liu Chiao [UNIFESP]; Pignatari, Shirley Shizue Nagata [UNIFESP]
    Objetivo: verificar a relacao entre a excursao do musculo diafragma e as curvaturas da coluna vertebral, em criancas respiradoras bucais. Metodo: Foram avaliadas 52 criancas de cinco a 12 anos de idade, de ambos os sexos e, segundo avaliacao otorrinolaringologica, foram divididas em dois grupos: respiradores bucais e respiradores nasais. Todos os participantes foram submetidos ao exame de videofluoroscopia do musculo diafragma, na qual a distancia excursionada foi analisada pelo programa Adobe Photoshop, e a avaliacao das curvaturas da coluna vertebral atraves de fotografias em norma lateral esquerda e analisadas pelo programa Software de Avaliacao Postural. Resultados: Os grupos estudados apresentaram diferenca estatisticamente significante quanto ao comportamento das curvaturas da coluna vertebral (lordose cervical: P=O,OO3; lordose lombar: P=O,OO1; cifose toracica: P=O,OO2; posicao da pelve: P=O,OO1) e da excursao do musculo diafragma (diafragma lado direito: P=O,OO1; diafragma lado esquerdo: P=O,OO1). O grupo respirador bucal apresentou a lordose cervical diminuida, aumento da cifose toracica, aumento da lordose lombar e anteversao da posicao da pelve, quando comparado com o grupo respirador nasal. A distancia excursionada pelo musculo diafragma em criancas respiradoras bucais foi menor que em criancas respiradoras nasais. Nao houve correlacao entre o comportamento das curvaturas da coluna vertebral com a excursao do musculo diafragma nos grupos estudados. Conclusao: As criancas respiradoras bucais apresentam diminuicao da lordose cervical,. aumento da cifose toracica, aumento da lordose lombar, anteversao da posicao da pelve e a distancia excursionada pelo musculo diafragma e menor, quando comparadas com criancas respiradoras nasais. Nao ha relacao entre as curvaturas da coluna vertebral com a excursao do musculo diafragma em criancas respiradoras bucais
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    Influência do trauma cirúrgico no comportamento dos níveis séricos de albumina após cirurgia da coluna vertebral
    (Sociedade Brasileira de Coluna, 2010-12-01) Luciano, Rafael Paiva [UNIFESP]; Leite, Marcio Squassoni [UNIFESP]; Martins, Délio Eulálio [UNIFESP]; Wajchenberg, Marcelo [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: to evaluate the variation of serum albumin concentration in surgery of the spine and its relation to clinical effects in the postoperative. METHODS: prospective observational study on the values of serum albumin of 55 patients undergoing spine surgery.Blood samples were collected one day before and 24 hours after the procedure. The paired t test was performed to evaluate the change parameters albumin, hemoglobin and hematocrit. The presence of association between the degree of variation in levels of albumin (<1 g/dL or >1 g/dL) and the variables of interest: complications, transfusions, procedures performed, patients' age and sex and diagnosis were assessed by χ2 test or the χ2 likelihood ratio when appropriate. RESULTS: the average reduction of this protein was of 0.58 g/dL, ranging from 0 to 1.8 g/dL. Of the patients, 78.2% showed albumin values in the postoperative period below the normal range. Only two patients presented with complications during the 30 days of follow-up. The group with the correction of deformities showed 100% of patients with variation of >1 g/dL. CONCLUSION: there was an influence of the surgical trauma in reducing serum albumin, on average, 0.58 g/dL in surgery of the spine. It was not possible to associate this decrease to complications in the postoperative period after 30 days of follow-up of these patients.
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    Lombalgia ocupacional
    (Associação Médica Brasileira, 2010-01-01) Helfenstein Junior, Milton [UNIFESP]; Goldenfum, Marco Aurélio; Siena, César; Universidade Federal de São Paulo (UNIFESP); Escola Superior de Gestão e Ciências da Saúde de Porto Alegre Curso de Pós-Graduação em Medicina do Trabalho; Universidade Tecnológica Nacional Buenos Aires; Justiça Federal 3ª região
    The occupational low back pain presents multifactorial aetiology, important prevalence and incidence. Characterized by pain of varying duration and intensity, low back pain may lead to disability. Low back pain causes suffering to workers, implies costs to companies, to the social security and health assistance system. Because of the theme's relevance, the authors have elaborated this review of literature with emphasis on a theoretical and conceptual basis, as well as experience of experts.
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    Modelo simulador para treinamento de punção transpedicular em vertebroplastia percutânea
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2007-08-01) Abdala, Nitamar [UNIFESP]; Oliveira, Ricardo Abdala Da Silva; Alves Junior, João De Deus Da Costa [UNIFESP]; Spinola, Tulio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UMDI Diagnósticos
    OBJECTIVE: To develop and test a model of the human lumbar vertebra for training transpedicular puncture in percutaneous vertebroplasty. MATERIALS AND METHODS: Thirty lumbar vertebra models were constructed from methacrylate, plaster and ethyl-vinyl-acetate, using a rubber mold of human vertebrae. The intervertebral discs were made of silicone to provide anatomical similarity and fusion of five vertebrae. This model of spinal column segment was positioned within a manikin with an ethyl-vinyl-acetate lining so that direct visualization was not possible. A theoretical course was given to six trainees in radiology and neuroradiology who have tested the models with respect to parameters of similarity with the reality, performing 30 transpedicular punctures in three series of ten punctures a day, with one-week interval between the series. RESULTS: Each student performed 30 transpedicular punctures; however, eight of these punctures were disregarded because of manufacturing defects of the dummies observed during the procedures. Similarity data forms were filled in by all of the trainees following the procedures, with 100% of positive answers as regards the models similarity with the human body. CONCLUSION: It was possible to develop a training model for transpedicular puncture with a satisfactory degree of similarity with the human body, constituting an appropriate tool for training in vertebroplasty.
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    Nível de atividade física dos estudantes da Unifesp - Baixada Santista em isolamento social associado a aulas em atividades domiciliares emergenciais e sua repercussão na coluna vertebral
    (Universidade Federal de São Paulo, 2022-01-24) Agustinho, Júlia Oliveira [UNIFESP]; Poletto, Patricia Rios [UNIFESP]; http://lattes.cnpq.br/7170962317109623; http://lattes.cnpq.br/8693541863734102; Universidade Federal de São Paulo (UNIFESP)
    Este estudo tem o objetivo de verificar as repercussões na coluna vertebral dos alunos da Universidade Federal de São Paulo, relacionadas à inatividade física, possivelmente advindas do isolamento social e o uso excessivo de dispositivos eletrônicos devido às aulas remotas. Este estudo possui caráter transversal analítico, realizado com estudantes da Universidade Federal de São Paulo que estavam em isolamento social e estudando através de aulas remotas adotadas por causa da pandemia de Covid-19. Foi solicitado ao voluntário que preenchesse um formulário constituído de 26 perguntas sobre a prática de atividade física, aulas remotas e uso de dispositivos eletrônicos, sono, estresse e sintomas como dor ou desconforto na coluna vertebral. Constatou-se que houve alta prevalência de dor lombar nos estudantes com exacerbação após o isolamento social, tendo como principal fator permanecer na mesma posição por longos períodos utilizando dispositivos eletrônicos para realizar atividades acadêmicas. O nível de atividade física foi reduzido, porém os estudantes mantiveram-se ativos através de plataformas online de exercícios, demonstrando a importância da tecnologia neste contexto.