Objectives: Given the small amount of information regarding the pathological and degenerative changes of the spine, this study was carried out in order to evaluate and quantify the angular values of sagittal balance in the obese population. Methods: We measured the angles of pelvic incidence (PI), pelvic version (PV) and sacral slope (SS). Results: We evaluated 30 patients, 19 females and 11 males, in 2012, who were to be submitted tobariatric surgery. The mean age was 33 years old. The mean BMI was 41 kg/m2, the mean value for men being 43 kg/ m2 and 39 kg/m2 for women. The mean PI was 57°. The PV was 19°. The DS was 38°. The value of pelvic incidence and pelvic version was on average higher than those found in people with normal body mass index. Regarding the sacral slope the value were the same of those of the normal population. Conclusions: Increasingly the sagittal balance has gained importance in the evaluation of the spine. It is necessary further literature and increasing medical knowledge of diseases and comorbidities that may alter sagittal balance in patients, such as obesity.Keywords: Obesity; Postural balance; Posture; Pelvis; Body mass index. RESUMO Objetivo: Tendo em vista a pouca quantidade de informações a respeito das alterações degenerativas e patológicas da coluna vertebral realizou-se este estudo com objetivo de avaliar e quantificar os valores angulares do equilíbrio sagital na população obesa. Métodos: Foram medidos os ângulos de incidência pélvica (IP), versão pélvica (VP) e declive sacral (DS
Spondylodiscitis due to Candida is a rare complication from hematogenic dissemination of infection caused by this fungus. We present an atypical case of spondylodiscitis caused by this germ that occurred after chest contusion and progressed with necrotizing fasciitis of the anterior region of the chest and osteomyelitis of the sternum. Through contiguity, it also affected the upper thoracic spine. The patient evolved with neurological alterations and recovered satisfactorily after appropriate treatment with surgical decompression of the spinal cord and specific antibiotic therapy.
Spondylodiscitis affecting the cervical spine is the most unusual type. Disease progression can be dramatic, even causing quadriplegia and death. We present an unusual case that progressed with osteolytic lesions between C2 and C3, causing cord compression and epidural abscess. The patient was treated surgically by a double approach and improved without neurological deficits and with better inflammatory markers. We reviewed the current literature on the subject.
Como citar este artigo: Kulcheski ÁL, et al. Espondilodiscite fúngica por Candida albicans: um caso atípico e revisão da literatura. Rev Bras Ortop. 2015. http://dx.doi.org/10.1016/j.rbo.2015.04.016 No. of Pages 4 r e v b r a s o r t o p . 2 0 1 5;x x x(x x):xxx-xxx w w w . r b o . o r g . b r Relato de caso Espondilodiscite fúngica por Candida albicans: um caso atípico e revisão da literatura ଝ informações sobre o artigo Histórico do artigo: Recebido em 18 de agosto de 2014 Aceito em 14 de novembro de 2014 On-line em xxx Palavras-chave: Candida albicans Discite Doenças da coluna vertebral r e s u m o A espondilodiscite por Candida albicans é uma rara complicação da disseminação hematogênica da infecção por esse fungo. Apresentamos um caso atípico de espondilodiscite por esse germe ocorrido após trauma contuso torácico que cursou com fasceíte necrotizante da região anterior do tórax, osteomielite de esterno e, por contiguidade, afetou a coluna vertebral torácica alta. O paciente evoluiu com alteração neurológica e recuperou--se satisfatoriamente após tratamento adequado com descompressão medular cirúrgica e antibioticoterapia específica. Discitis Spinal diseases a b s t r a c t Spondylodiscitis due to Candida is a rare complication from hematogenic dissemination of infection caused by this fungus. We present an atypical case of spondylodiscitis caused by this germ that occurred after chest contusion and progressed with necrotizing fasciitis of the anterior region of the chest and osteomyelitis of the sternum. Through contiguity, it also affected the upper thoracic spine. The patient evolved with neurological alterations and recovered satisfactorily after appropriate treatment with surgical decompression of the spinal cord and specific antibiotic therapy ARTICLE IN PRESS
OBJECTIVE:The objective of this study is to compare the clinical outcome among patients who are surgically treated for lumbar disc herniation by transforaminal and interlaminar endoscopy techniques. METHODS:For the treatment of lumbar disc herniation, 31 patients were assigned to undergo the interlaminar technique and 24 patients the transforaminal technique. They were evaluated using visual analog scale and Oswestry disability index in the preoperative period, in the first postoperative period, and in the 12th month after the procedure. The clinical results between the two techniques were then compared.RESULTS: Overall, 89.1% of the patients obtained good results, with 12.5% complications in the transforaminal technique and 9.6% in the interlaminar technique.CONCLUSION: Although both the endoscopic techniques, compared in this study, are safe and effective for the surgical treatment of lumbar herniated disc, the interlaminar technique presented significantly better results and lower rates of complications than the transforaminal technique.
Resumo Objetivo Analisar uma série de casos de fraturas complexas do sacro com dissociação espinopélvica tratados cirurgicamente com fixação iliolombar, e revisar a literatura médica existente. Métodos Para a análise, foram avaliados retrospectivamente os prontuários médicos de casos operados utilizando a técnica de Schildhauer et al para fixação. O período de acompanhamento foi de pelo menos 12 meses. Os resultados funcionais foram avaliados por meio da escala visual analógica (EVA) de dor e do índice de incapacidade de Oswestry, versão 2.0. Os dados foram comparados com os da literatura médica existente. Resultados Seis casos foram analisados, sendo que quatro evoluíram com incapacidade moderada, um, com incapacidade mínima, e um, com incapacidade grave. Três casos que apresentavam déficit neurológico obtiveram melhora significativa. Apenas um caso evoluiu com complicação tromboembólica pulmonar. Conclusão A técnica de Schildhauer et al é eficiente para a fixação de fraturas complexas de sacro com dissociação espinopélvica. Os pacientes evoluíram com bons resultados funcionais. A liberação precoce de sustentação de carga demonstrou-se segura com o uso deste tratamento.
Objective The objective of the study was the development of a low cost simulator of the endoscopic lumbar spine flavectomy technique for use as a teaching method in order to make endoscopic training more accessible. Methods The study was a descriptive research project conducted at the Orthopedic Skills Laboratory of the Health Sciences Department of the Federal University of Paraná. Easily accessible, low cost materials, such as a commercial-use mannequin, EVA plastic, PVC and copper tubing were used to develop the simulator.. Results At the end of the project, it was possible to build a simulator of the endoscopic lumbar spine flavectomy technique with a budget of approximately 464 BRL, or approximately 140 USD. Conclusions We concluded that it was possible to build an endoscopic lumbar spine flavectomy technique simulator on a budget of less than half a Brazilian minimum monthly wage, which makes training more accessible to academics, residents and surgeons. Level of Evidence V; Expert opinion.
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