Objective: The adolescent idiopathic scoliosis (AIS) is a spine deformity that occurs in both the coronal plane and the sagittal plane of patients between 10 and 17 years. The Cobb method is the most widely used to determine the angular value of scoliosis and it is defined as the "gold standard". The goal is to verify the reproducibility of the measured angles between orthopedic residents and spinal pathologies specialists, comparing the variability of the angles measured by professionals with greater and lesser experience. Method: A total of 10 radiographs of patients diagnosed with AIS were assessed. Radiographs were handed over to 7 orthopedists specialized in spine and 14 orthopedic residents. The measurement of the angles for each of the examiners was described using means and standard deviations and intraclass correlations were calculated, as well as the measure of repeatability, and Bland-Altman plots were designed with the results of the measurements of each group of examiners, according to experience, to assess the agreement/reproducibility of Cobb angle measurements. Results: Each examiner obtained a resulting average of 10 cases summation. In order to assess trends in variability of the measurements of the angles of each group graphs were plotted based on the arithmetic mean of each of the 10 cases by the total number of participants in the group versus the standard deviation in each case. Conclusion: There was a poor correlation (ICC=0.4) in the measurement of Cobb in both groups, demonstrating difficulties in the method, which cannot be overcome by the expertise.
OBJETIVO: Analisar os resultados da cirurgia de corpectomia e artrodese por via anterior nos pacientes com fratura tipo explosão da coluna toracolombar e com osteoporose, que foram submetidos a tratamento conservador prévio por no mínimo sete meses, sem melhora importante do quadro doloroso. MÉTODOS: Foram tratadas seis pacientes idosas com fratura-explosão da coluna toracolombar em um único nível, depois de, no mínimo, sete meses do trauma, pela via anterior, com corpectomia, uso de enxerto autólogo de costela e fixação com parafusos pediculares nos níveis adjacentes. A dor foi avaliada pela EVA no pré-operatório, três semanas, três meses, seis meses e um anos após a cirurgia. RESULTADO: As pacientes apresentaram melhora significativa da dor pós-operatória, com diminuição substancial do uso de medicação analgésica. CONCLUSÕES: Os autores recomendam a via anterior isolada como método de tratamento para fraturas tipo explosão crônicas em pacientes com osteoporose pela baixa taxa de complicações e pelos resultados satisfatórios encontrados.
OBJETIVO: os autores realizaram um estudo e compararam o resultado radiográfico no uso de hidroxiapatita e enxerto de crista ilíaca (autólogo) no tratamento cirúrgico de hérnia discal cervical em um nível, sendo realizada artrodese cervical anterior com placa. MÉTODOS: foi realizado estudo retrospectivo com pacientes submetidos à artrodese cervical comparando-se dois grupos de dez pacientes: um em que foi utilizado enxerto de hidroxiapatita e outro em que foi utilizado enxerto de crista ilíaca (autólogo). Radiografias pós-operatórias foram mensuradas e comparadas, à busca de perdas de alinhamento angular. RESULTADOS: os dois tipos de enxerto demonstraram manter alinhamento em taxas similares, sendo observada consolidação óssea em todos os pacientes. O estudo não mostrou fragmentação do enxerto de hidroxiapatita ou soltura do material de síntese. CONCLUSÃO: nesta pequena série de casos não foi observada diferença significativa entre os resultados da artrodese cervical anterior com enxerto de hidroxiapatita em relação ao enxerto autólogo de ilíaco.
Sacropelvic fixation arose from the need to protect the sacral instrumentation in long constructions, due to failures in the implant-bone interface and the treatment of diseases in which there is no possibilities of sacral fixation such as infections and tumors. Due to anatomic difficulties and the complex spinopelvic biomechanics several techniques were developed. The fixation with iliac screws has become according to multiple studies, a well-established technique that minimizes frequent complications such as pseudoarthrosis and implant failure. However, it has disadvantages such as iliac wing fracture and skin lesions due to the protrusion of materials. The present study aims to comprehensively review the literature on the technique taking into account relevant aspects to its better knowledge and application. Level of evidence III; Therapeutic Study.
With the increase in the elderly population worldwide, the prevalence of degenerative diseases tends to grow, especially degenerative disc disease (DDD) in the lumbar spine. It is important to seek excellence treatments to ensure a better quality of life for patients. In this sense, the total disc replacement and the use of prostheses in the lumbar spine have been pointed out as alternative and promising treatments when compared to the standard treatment. The aim of this study is to show the results of total replacement of the intervertebral disc, through a review of the literature. The electronic search was performed in the PubMed databases, with the keywords “Total Disk Replacement”, “Low Back Pain”, and “Arthroplasty” in articles published as of 2012. We selected 16 articles. Level of Evidence: II. Type of study: Systematic reviewb of Level II studies or Level I studies with inconsistent results.
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