ObjectiveTo compare the interlaminar and transforaminal block techniques with regard to the state of pain and presence or absence of complications.MethodThis was a randomized double-blind prospective study of descriptive and comparative nature, on 40 patients of both sexes who presented lumbar sciatic pain due to central-lateral or foraminal disk hernias. The patients had failed to respond to 20 physiotherapy sessions, but did not present instability, as diagnosed in dynamic radiographic examinations. The type of block to be used was determined by means of a draw: transforaminal (group 1; 20 patients) or interlaminar (group 2; 20 patients).ResultsForty patients were evaluated (17 males), with a mean age of 49 years. There was a significant improvement in the state of pain in all patients who underwent radicular block using both techniques, although the transforaminal technique presented better results than the interlaminar technique.ConclusionBoth techniques were effective for pain relief and presented low complication rates, but the transforaminal technique was more effective than the interlaminar technique.

Objective : Compare the interlaminar blocking technique with the transforaminal blocking, with regard to pain and the presence or absence of complications. Methods : Prospective, descriptive and comparative, double-blind, randomized study, with 40 patients of both sex suffering from sciatic pain due to central-lateral or foraminal disc herniation, who did not respond to 20 physiotherapy sessions and had no instability diagnosed on examination of dynamic radiography. The type of blocking, transforaminal or interlaminar, to be performed was determined by draw. Results : We evaluated 40 patients, 17 males, mean age 49 years, average VAS pre-blocking of 8.85, average values in transforaminal technique in 24 hours, 7, 21, and 90 days of 0.71, 1.04, 2.33 and 3.84, respectively; the average VAS post-blocking for interlaminar technique was 0.89, 1.52, 3.63 and 4.88. The techniques differ only in the post-blocking period of 21 days and overall post-blocking, with significance of p=0.022 and p=0.027, respectively. Conclusion : Both techniques are effective in relieving pain and present low complication rate, and the transforaminal technique proved to be the most effective.

ObjectiveTo evaluate bone mineral density among patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy.MethodsThis was a descriptive prospective study in which both bone densitometric and anthropometric data were evaluated. The inclusion criteria used were that the patients should present quadriplegic cerebral palsy, be confined to a wheelchair, be between 10 and 20 years of age and present neuromuscular scoliosis.ResultsWe evaluated 31 patients (20 females) with a mean age of 14.2 years. Their mean biceps circumference, calf circumference and body mass index were 19.4 cm, 18.6 cm and 16.9 kg/m2, respectively. The mean standard deviation from bone densitometry was −3.2 (z-score), which characterizes osteoporosis.ConclusionThere is high incidence of osteoporosis in patients with neuromuscular scoliosis secondary to quadriplegic cerebral palsy.

ObjectiveTo determine whether the use of autograft associated with platelet-rich plasma (PRP) increases bone healing in patients undergoing lumbar fusion.MethodThis was a prospective, descriptive, and comparative study, which included 40 patients undergoing lumbar fusion, who were divided into two groups: group I, autograft only, and group II, autograft associated with PRP. After surgery, patients were followed-up on the first, third, and sixth month. The Molinari radiographic classification and Glassman tomographic classification were used as criteria to analyze the bone consolidation.ResultComparing the group I with group II, according to the criteria of Molinari, bilateral fusion was observed in 27.5% of the patients in group I in the first month after surgery. In group II, the rate of bilateral fusion was 25.0% and 20% in the third and sixth months, respectively. The results of computed tomography scans performed at six months after surgery indicated, according to the criteria of Glassman, a rate of bilateral solid fusion of 15.0% and 10.0% in groups I and II, respectively.ConclusionThe use of PRP showed no significant difference in bone healing in cases of lumbar arthrodesis.

OBJETIVO: Avaliar a presença e o crescimento microbiológico no sítio operatório em pacientes submetidos a tratamento cirúrgico de escoliose idiopática do adolescente na primeira, segunda e terceira hora de cirurgia. Casuística e MÉTODO: Estudo prospectivo, de caráter descritivo e comparativo, sendo avaliados 34 pacientes portadores de escoliose idiopática do adolescente com indicação cirúrgica, analisando a contaminação no sítio cirúrgico através da bacterioscopia e cultura óssea na primeira, segunda e terceira hora de cirurgia. RESULTADOS: Houve bacterioscopia positiva crescente entre a primeira e a segunda hora de cirurgia. A cultura confirma a colonização da ferida operatória, crescente entre as horas analisadas. CONCLUSÕES: O tempo cirúrgico prolongado está diretamente relacionado ao maior crescimento microbiológico no sítio cirúrgico de pacientes submetidos à correção de escoliose vertebral.

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Objective: To evaluate the complications inherent in the use or not of continuous suction drain in postoperative period of patients undergoing 1-level lumbar arthrodesis. Methods: An analytical, comparative, randomized study was performed with a sample of 60 patients submitted to 1-level 360 o lumbar arthrodesis with TLIF technique, 30 of whom used the suction drain for three days after surgery and another 30 did not use the suction drain in the postoperative period. The complications that occurred on the 3rd, 14th, and 28th postoperative days of patients of both groups and the Visual Analog Scale for pain were evaluated and compared. The complications assessed were seroma, superficial infection and suture dehiscence. Results: A total of 23.3% surgical wound complications were found, the most frequent being seroma (16%). In total, each group presented seven complications. There were no statistical differences observed in the evaluation of seroma, infection, wound dehiscence on the 3rd, 14th, and 28th postoperative days in both groups. Conclusion: The use or not of suction drain in 1-level lumbar surgeries does not interfere with complications such as seroma, infection, and suture dehiscence.Keywords: Arthrodesis; Spine; Spine fusion; Seroma; Surgical wound dehiscence; Infection. RESUMO