RESUMOEste trabalho propõe um parâmetro anatômico, a incidência pélvica, como fator chave para a compreensão do alinhamento da coluna vertebral. Existe estreita relação, tanto para indivíduos normais como para indivíduos com deformidades da coluna, entre o parâmetro anatômico de incidência pélvica e a inclinação sacral, determinantes da lordose lombar. O ângulo de Cobb e a rotação vertebral apical servem de instrumento para o entendimento do aspecto tridimensional da coluna vertebral e das relações entre a pelve e a coluna. Uma equação preditiva para lordose é apresentada. A incidência pélvica parece ser o fator determinante do equilíbrio sagital da coluna. Ela determina as curvas da coluna vertebral, variando conforme outros parâmetros.Descritores: Pelve; Lordose; Escoliose; Equilíbrio sagital; Postura. ABSTRACT this paper proposes an anatomical parameter, the pelvic incidence, as the key factor for managing the spinal balance. there is a close relationship for both normal individuals and those with spinal deformities between the anatomical parameter of pelvic incidence and the sacral slope, which determine lumbar lordosis. the Cobb angle and the apical vertebral rotation serve as a tool for understanding the three-dimensional aspect of the spine and its relationships with the pelvis. A predictive equation of lordosis is postulated. the pelvic incidence seems to be the determining factor of the sagittal balance of the spine. It determines spinal curves and varies according to other parameters.
OBJETIVOS: Este artigo tem por objetivo avaliar a presença de alterações do platô vertebral (Modic) e a sua associação com a instabilidade demonstrada nas radiografias em flexo-extensão e neutra no plano sagital. MÉTODOS: Análise seccional dos estudos de imagens realizados no serviço de radiologia do Hospital Mãe de Deus em Porto Alegre (RS), entre o período de julho de 2008 e fevereiro de 2010, em 115 pacientes. Foram analisados os segmentos de L1 a S1, num total de 575 segmentos nos exames radiográficos e de ressonância nuclear magnética. RESULTADOS: Analisou-se 115 pacientes sendo 59 (51,30%) do sexo feminino e 56 (48,70%) do sexo masculino. A idade variou de 13 anos e seis meses a 81 anos e dois meses com uma média de 43 anos e oito meses. Com os critérios utilizados, observou-se 224 segmentos instáveis e 351 segmentos estáveis. O Modic I apresentou-se em sete segmentos instáveis e em 22 segmentos estáveis. Quanto à prevalência, o segmento L4-L5 foi o mais instável, correspondendo por 32,58% de todos os segmentos instáveis. CONCLUSÃO: Este artigo refuta a idéia de que as alterações de Modic tipo I estejam associadas a segmentos instáveis.
STUDY DESIGN: Systematic review of the literature. OBJECTIVE: To perform a systematic review of the literature to organize, critical appraisal and select the best evidence available about the efficacy and safety of non-fusion fixation and its potential use for patients with degenerative disc, spinal stenosis and low back pain. SUMMARY OF BACKGROUND DATA: Recent reports have increased debate about the role of dynamic stabilization in the treatment of chronic back pain associated with lumbar disc degeneration and spinal stenosis. We conducted a systematic review of randomized trials through a more sensitivity search strategy and rigorous criteria applied for the type of studies. METHODS: An electronic search was made in the databases of the Cochrane Central Register of Controlled Trials, Medline, Embase, and Latin American and Caribbean Health Sciences (Lilacs) extended to November 31, 2008, with no linguistic restrictions. RESULTS: One randomized controlled trial that fulfilled the inclusion criteria described above was included in this review. CONCLUSION: The data included in this review show that the use of non-fusion stabilization could be a suitable alternative to another therapies in well selected patients with spinal stenosis and degenerative disc disease. This review highlighted the need for continued research into the use of non-fusion stabilization in the treatment of spinal disorders. There is an urgency need to conduct randomized clinical trials. Long-term efficacy should be evaluated.
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