ABSTRACT
Objective: To evaluate the preliminary results of the surgical treatment through minimally invasive fixation technique in patients with thoracolumbar spinal fractures. Methods: Retrospective study of 17 patients with fractures of thoracolumbar vertebrae who underwent surgery with percutaneous fixation in the period of 2009 to 2011. The clinical evaluation of the results was performed using the SF-36 and Oswestry questionnaires. The radiographic parameters evaluated were: fracture classification according to Magerl's criteria, wedge angle of the fractured vertebrae and bisegmental Cobb angle. These measurements were made in the preoperative, immediate postoperative and 1 year after surgery. Other data such as associated injuries, neurological deficit, post-surgical infection, loosening and breakage of implants were also considered. Results: The data revealed average scores above 80% in all domains of the SF-36 questionnaire while in Oswestry Questionnaire, 79% of patients had minimal or absent physical limitations with a mean score of 12.4±11.89%. The average Cobb angle for preoperative kyphosis was 5.53º±13.80o, 2.18º±13.38o in the early postoperative period and 5.26º±13.95o one year after surgery. The average correction obtained after surgery was 3.35º and the average correction loss was 3.19º. No complications such as post-surgical infection, permanent neurological deficits and implant loosening and breakage were observed. ...
Objetivo: Avaliar os resultados preliminares do tratamento cirúrgico pela técnica de fixação minimamente invasiva em pacientes portadores de fraturas toracolombares da coluna vertebral. Métodos: Estudo retrospectivo de 17 pacientes com fraturas de vértebras toracolombares submetidos a tratamento cirúrgico com fixação percutânea no período de 2009 a 2011. A avaliação clínica dos resultados foi realizada através dos questionários SF-36 e Oswestry. Os parâmetros radiográficos avaliados foram: classificação das fraturas segundo critérios de Magerl, ângulo de acunhamento da vértebra fraturada e o ângulo de Cobb bissegmentar do segmento afetado. Estas medidas foram feitas nos períodos pré-operatório, pós-operatório imediato e 1 ano após a cirurgia. Outros dados como lesões associadas, déficit neurológico, infecção pós-cirúrgica, soltura e quebra de implantes também foram considerados. Resultados: Os dados obtidos revelaram médias acima de 80% em todos os domínios do Questionário SF-36 enquanto que no Questionário de Oswestry, 79% dos indivíduos apresentaram limitações físicas mínimas ou ausentes com escore médio de 12,4%±11,89. O valor ...
Objetivo: Evaluar los resultados preliminares de la técnica de tratamiento quirúrgico para la fijación mínimamente invasiva en pacientes con fracturas de la columna toracolumbar. Métodos: Estudio retrospectivo de 17 pacientes con fracturas de vértebras toracolumbares fueron sometidos a cirugía con fijación percutánea en el período de 2009 a 2011. Se realizó la evaluación clínica de los resultados utilizando los cuestionarios SF-36 y Oswestry. Se evaluaron los parámetros radiográficos: clasificación de fracturas según criterios de Magerl, ángulo de acuñamiento de la vértebra fracturada y el ángulo de Cobb bissegmentar del segmento afectado. Estas mediciones se realizaron en el preoperatorio, postoperatorio inmediato y 1 año después de la cirugía. También se consideraron otros datos, tales como lesiones asociadas, déficit neurológico, infección post-quirúrgica y aflojamiento y rotura de los implantes. Resultados: Los datos indican promedios superiores al 80% en todos los dominios del cuestionario SF-36, mientras que en cuestionario Oswestry, el 79% de los pacientes tenían limitaciones físicas mínimas o ausentes con una puntuación media de 12,4±11,89%. El ángulo de Cobb preoperatorio promedio fue 5,53º&...
Subject(s)
Humans , Spinal Fractures/surgery , Postoperative Complications , Minimally Invasive Surgical Procedures , Fracture FixationABSTRACT
Objective: To evaluate the clinical and radiological results of treatment of patients with spondylodiscitis. Methods: Imaging exams used in this study were plain radiographs and magnetic resonance imaging of the spine. Results: Data from 33 patients, 10 (30.3%) females and 23 (69.7%) males were evaluated. The average time to diagnosis was four months and 28 days (SD ± 1 month and 28 days) and 19 patients (57.5%) presented neurological deficit. Surgical treatment was performed in 22 patients (66.6%) and three patients (9.1%) had complications from the surgery. Conclusions: Despite technological advances in complementary exams, early diagnosis of spondylodiscitis remains a challenge. However, drug treatment associated with surgery shows good results. .
Objetivo: Avaliar os resultados clínicos e radiológicos do tratamento de pacientes portadores de espondilodiscite. Métodos: Os exames de imagem utilizados neste estudo foram radiografias simples e ressonância magnética da coluna vertebral. Resultados: Foram avaliados os dados de 33 pacientes, sendo 10 (30,3%) do sexo feminino e 23 (69,7%) do sexo masculino. O tempo médio gasto para o diagnóstico foi de 4 meses e 28 dias (DP ± 1 mês e 28 dias) e 19 pacientes (57,5%) apresentavam déficit neurológico. O tratamento cirúrgico foi realizado em 22 pacientes (66,6%) e três pacientes (9,1%) apresentaram complicações decorrentes do tratamento cirúrgico. Conclusões: Apesar do avanço tecnológico nos exames complementares, o diagnóstico precoce da espondilodiscite continua sendo um desafio. No entanto, o tratamento medicamentoso associado ao procedimento cirúrgico apresenta bons resultados. .
Objetivo: Evaluar los resultados clínicos y radiológicos de tratamiento de pacientes con espondilodiscitis. Métodos: Las pruebas de imagen utilizadas en este estudio fueron las radiografías simples y resonancia magnética de la columna vertebral. Resultados: Los datos de 33 pacientes, 10 (30,3 %) del sexo femenino y 23 (69,7%) del sexo masculino fueron evaluados. El tiempo medio hasta el diagnóstico fue de 4 meses y 28 días (DE ± 1 mes y 28 días) y 19 pacientes (57,5%) tuvieron déficit neurológico. El tratamiento quirúrgico se realizó en 22 (66,6%) pacientes y 3 (9,1%) tuvieron complicaciones de la cirugía. Conclusiones: A pesar de los avances tecnológicos en los exámenes complementares, el diagnóstico precoz de espondilodiscitis sigue siendo un desafío. Sin embargo, el tratamiento farmacológico asociado con la cirugía presenta buenos resultados. .
Subject(s)
Humans , Discitis/diagnostic imaging , Discitis/surgery , Discitis/therapy , Treatment OutcomeABSTRACT
INTRODUCTION: Chronic pelvic pain is a disease that directly affects the social and professional lives of women. OBJECTIVE: To estimate the prevalence of this clinical condition and to identify independent factors associated with it in women living in Ribeirão Preto, Brazil. METHODS: A one-year cross-sectional study was conducted in a population sample of 1,278 women over the age of 1,278 women over the age of 14 years. The target population was predominantly composed of women who are treated by the public health system. The questionnaire was administered by interviewers who were not linked to the city health care programs. The prevalence of the morbidity was estimated. First, we identified the significant variables associated with pelvic pain (p<0.10) and then we attributed values of 0 or 1 to the absence or presence of these variables. Logistic regression analysis was used to identify and estimate the simultaneous impact of the independent variables. The results were expressed by odds ratio and their 95 percent confidence interval with p<0.05. RESULTS: The disease was found in 11.5 percent (147/1,278) of the sample. The independent predictors were dyspareunia, previous abdominal surgery, depression, dysmenorrhea, anxiety, current sexual activity, low back pain, constipation, urinary symptoms, and low educational level. CONCLUSION: The prevalence of chronic pelvic pain in Ribeirão Preto is high and is associated with conditions that can usually be prevented, controlled, or resolved by improvement of public health policies and public education.