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

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Objective: to validate a lumbar spine endoscopic flavectomy simulator using the construct method and to assess the acceptability of the simulator in medical education. Methods: thirty medical students and ten video-assisted surgery experienced orthopedists performed an endoscopic flavectomy procedure in the simulator. Time, look-downs, lost instruments, respect for the stipulated edge of the ligamentum flavum, regularity of the incision, GOALS checklist (Global Operative Assessment of Laparoscopic Skills), and responses to the Likert Scale adapted for this study were analyzed. Results: all variables differed between groups. Procedure time was shorter in the physician group (p < 0.001). Look-downs and instrument losses were seven times greater among students than physicians. Half of the students respected the designated incision limits, compared to 80% of the physicians. In the student group, about 30% of the incisions were regular, compared to 100% in the physician group (p < 0.001). The physicians performed better in all GOALS checklist domains. All the physicians and more than 96% of the students considered the activity enjoyable, and approximately 90% believed that the model was realistic and could contribute to medical education. Conclusions: the simulator could differentiate the groups’ experience level, indicating construct validity, and both groups reported high acceptability.

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.

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.

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.

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