Navegando por Palavras-chave "Spine"

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    An alternative didactic, functional and topographic systematization of the spinal muscles
    (Elsevier Gmbh, Urban & Fischer Verlag, 2017) de Araujo Baptista, Vivianne Izabelle [UNIFESP]; Mayer, William Paganini; da Silva, Ricardo Eustaquio; de Vasconcellos Fontes, Ricardo Braganca; Baptista, Josemberg da Silva
    Back muscles are commonly described in a topographically-oriented manner without necessarily following morphological criteria. In this manner, non-standard terms may be employed which convey incorrect Morphological concepts and demanding more time from both faculty and students to transmit knowledge. We propose a classification system for spinal muscles incorporating morphological concepts with the goal of facilitating knowledge transfer and suggest the term "spinal muscles". Those muscles were systematically divided and classified in seven strata from anterior to posterior: vertebro-appendicular (VA), transversarium (Tr), deep post-transversarium (DPT), middle post-transversarium (MPT), superficial post-transversarium (SPT), deep spino-appendicular (DSA) and superficial spino-appendicular (SSA). Besides topography and function, this system incorporates innervation and embryological origins of each muscle. The extrinsic (VA, DSA, SSA) or intrinsic (Tr, DPT, MPT, SPT) nature of these muscles in relation to the spine and also the topographic relationship to the transverse process is represented in this system. Specific areas of functional, nervous and developmental transition exist on Tr and DPT strata due to being adjacent to extrinsic strata. We believe this system represents a more modern and concise teaching strategy for back muscles which may be employed partially or fully within any program. We envision its full version may be particularly useful in postgraduate medical training for specialties dealing with the spinal column such as neurosurgery, orthopedic surgery and physical medicine and rehabilitation. (C) 2017 Elsevier GmbH. All rights reserved.
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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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    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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    Functional aerobic exercise capacity limitation in adolescent idiopathic scoliosis
    (Elsevier B.V., 2014-10-01) Sperandio, Evandro Fornias [UNIFESP]; Alexandre, Anderson Sales [UNIFESP]; Yi, Liu Chiao [UNIFESP]; Poletto, Patrícia Rios [UNIFESP]; Gotfryd, Alberto O.; Vidotto, Milena Carlos [UNIFESP]; Dourado, Victor Zuniga [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Santa Casa da Misericordia Santos Hosp
    BACKGROUND CONTEXT: Exercise limitation has been described in patients with adolescent idiopathic scoliosis (AIS); however, whether the walking performance is impaired in these patients should be elucidated.PURPOSE: Thus, we aimed to evaluate the physiologic responses to the incremental shuttle walk test (ISWT) in patients with AIS.STUDY DESIGN/SETTING: Cross-sectional study.PATIENT SAMPLE: Twenty-nine patients with AIS and 20 healthy adolescents aged between 11 and 18 years old.OUTCOME MEASURES: Oxygen uptake (VO2), incremental shuttle walk distance (ISWD), Delta VO2/Delta walking velocity, Delta HR/Delta VO2, Delta VE/Delta VCO2, and linearized Delta tidal volume (VT)/Delta lnVE, forced expiratory volume in the first second of expiration (FEV1), and forced vital capacity (FVC).METHODS: We performed two ISWTs, and the data used were acquired in the second test. We also evaluated the lung function and respiratory muscle strength through spirometry test and manovacuometry, respectively. All authors confirm that there are no conflicts of interest. To compare the means or medians of variables between patients and healthy subjects, we used the unpaired t test or Mann-Whitney U test, respectively. the correlations were assessed by Pearson or Spearman coefficients according to the distribution of the studied variables. the probability of alpha error was set at 5% for all analyses.RESULTS: Adolescent idiopathic scoliosis patients showed significant lower values of ISWD, VO2, and ventilation at the end of the ISWT, as well as lower FEV1 and FVC; they also presented significantly shallower slope of Delta VT/Delta lnVE, whereas VO2 related significantly with ISWD (r = 0.80), FVC (r = 0.78), FEV1 (r = 0.73), and Delta VT/Delta lnVE (r = 0.58).CONCLUSIONS: Adolescent idiopathic scoliosis correlated to walking limitation and was associated to reduced pulmonary function and worse breathing pattern during exercise. Our results suggest that walking-based aerobic exercises should be encouraged in these patients. (C) 2014 Elsevier Inc. All rights reserved.
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    Impactos do teletrabalho nos servidores da Universidade Federal de São Paulo durante a pandemia da Covid-19
    (Universidade Federal de São Paulo, 2022-01-25) Lima, Ana Carolina Baraúna [UNIFESP]; Poletto, Patricia Rios [UNIFESP]; http://lattes.cnpq.br/7170962317109623; Universidade Federal de São Paulo (UNIFESP)
    Diante do cenário mundial marcado pela pandemia da Covid-19, medidas de distanciamento social foram implementadas com o propósito de controlar a disseminação do vírus Sars-Cov-2. Por consequência, muitos indivíduos precisaram se adaptar ao formato do teletrabalho. O presente estudo teve como objetivo identificar as adaptações realizadas pelos servidores da Universidade Federal de São Paulo - Campus Baixada Santista, bem como verificar a presença de dores e desconfortos relatada por esses trabalhadores durante o contexto pandêmico. As informações foram obtidas por meio do preenchimento de um formulário elaborado na plataforma Google Forms. Esses dados foram analisados por meio de estatística descritiva e foram apresentados o valor absoluto e o percentual das variáveis, de acordo com as características analisadas. Observou-se que os servidores precisaram se adaptar rapidamente ao novo contexto e utilizar meios próprios para garantir a realização de suas atividades no teletrabalho. Diante disso, verificou-se que as adaptações realizadas pelos trabalhadores envolvem: a insuficiência de recursos e/ou capacitação para a realização das atividades durante a pandemia (1), o aumento da jornada de trabalho (2), o aumento da percepção de estresse (3) e a redução dos níveis de atividade física (4). Parte das alterações observadas podem interferir no surgimento e/ou na intensificação de dores e desconforto nas coisas. Ambos os sinais foram relatados pela maioria dos servidores. As informações abordadas no presente estudo podem servir de auxílio para a universidade encontrar caminhos a serem seguidos tanto no período de teletrabalho, que ainda é uma realidade, quanto no processo de retorno dos servidores ao trabalho presencial.
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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 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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    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.
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    Acesso aberto (Open Access)
    Perfil do cirurgião de coluna brasileiro
    (Sociedade Brasileira de Coluna, 2013-01-01) Alves, Pedro Luz [UNIFESP]; Ueta, Fernando Tadashi Salvioni [UNIFESP]; Ueta, Renato Hiroshi Salvioni [UNIFESP]; Del Curto, David [UNIFESP]; Martins, Délio Eulálio [UNIFESP]; Wajchenberg, Marcelo [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To conduct cross-sectional study identifying the profile of the Brazilian spinal surgeon. METHODS: Data were collected through a questionnaire with multiple alternatives during two major events for spine surgery at national level in 2011, the Congresso da Sociedade Brasileira de Coluna (Congress of the Brazilian Spine Society) and Simpósio Internacional de Coluna (International Spine Symposium, SINCOL). The data were submitted to statistical analysis comparing and stratifying the information obtained according to the profile. RESULTS: We obtained 182 questionnaires answered by orthopedists and neurosurgeons with peculiarities and similarities on their medical management. CONCLUSIONS: The data obtained in this study may be important for the development of health policies in the spine surgery in Brazil.
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    Polimorfismo do gene da eca e da α-actinina 3 na escoliose idiopática do adolescente
    (Sociedade Brasileira de Ortopedia e Traumatologia, 2013-06-01) Wajchenberg, Marcelo [UNIFESP]; Luciano, Rafael de Paiva [UNIFESP]; Araújo, Ronaldo de Carvalho [UNIFESP]; Martins, Délio Eulálio [UNIFESP]; Puertas, Eduardo Barros [UNIFESP]; Almeida, Sandro Soares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: The I/D polymorphism of angiotensin-converting enzyme (ACE) and R577X of the α-actinin-3 (ACTN3) is related to changes in skeletal muscle function. The aim of this study was to evaluate the distribution of these polymorphisms in a family with multiple members with adolescent idiopathic scoliosis (AIS). METHODS: Evaluated 25 subjects from a family with multiple members with AIS, by collecting 10mL of blood for DNA isolation. The genotyping of the I/D polymorphism of the ACE gene and the R577X of the ACTN3 gene was performed using two specific primers to classify individuals as homozygous or heterozygous. RESULTS: Regarding the ACE polymorphism it was found that 19 (76%) subjects were DD and 6 (24%) ID. The prevalence of the D allele was 88% and the I allele was 12%. Regarding the ACTN3 polymorphism there were 6 subjects RR (24%), 11 RX (44%) and 8 XX (32%). The prevalence of the R allele was 23 (46%) and the X allele was 27 (54%). CONCLUSION: There was a difference between the distribution of the polymorphism of ACE and ACTN3 in the family studied. When assessing the ACE polymorphism a higher prevalence of the D allele was observed as compared with the I allele. Level of evidence iii, cross-sectional, clinical trial.
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    Prevalência e relação de fatores emocionais e clínicos em pacientes com discopatia degenerativa
    (Sociedade Brasileira de Coluna, 2010-06-01) Amaral, Vivian; Marchi, Luis; Oliveira, Leonardo [UNIFESP]; Pimenta, Luiz; Santa Casa de Misericórdia de São Paulo Instituto de Patologia da Coluna; Instituto da Patologia de Coluna; Universidade Federal de São Paulo (UNIFESP); Universidade de San Diego Instituto de Patologia da Coluna
    OBJECTIVES: to describe the psychosocial conditions, at the time of surgical indication, of patients with chronic low back pain caused by degenerative disc disease. METHODS: in a series of 32 cases of degenerative disc disease elective surgery, a psychological evaluation was performed before the surgery. In this evaluation, socio-demographic data were collected: gender; age; present working status; occurrence of withdrawal due to disability; and clinical-psychological data: pain; physical restraint; use of psychiatric medication controlled; degree of anxiety; degree of depression; degree of hopelessness; expectations before the surgical goal. RESULTS: the group was composed of 13 women and 14 men, mean age of 44.3 years old (23 to 65 years). The parameters of pain and physical restraint were compared to cases usually indicative of surgery, indicating no peculiarity in the studied group. We demonstrated a high and correlated prevalence of psychological changes in patients: 50% of depression, 54% of anxiety and 22% of hopelessness. Furthermore, it was possible to show high rates of absence from work due to physical disability and relation to the presence of anxiety and/or depression with cases in which expectations were misleading according to the surgical objective. CONCLUSIONS: chronic low back pain is accompanied by clinical pictures of pain and psychological disorders such as anxiety, depression and hopelessness. These parameters indicate the need for pre-surgical psychological evaluation and posterior follow-up, aiming at the rehabilitation of the patient.