cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14288946.v1
title: INCIDENCE OF SPINAL CANCER IN A TERTIARY CARE HOSPITAL IN MEXICO

description: ABSTRACT Objective To determine the incidence of primary malignant bone tumors of the spine in a High Specialty Orthopedics and Traumatology Medical Unit. Methods Review study. The study included patients receiving benefits from the Mexican Social Security Institute of all ages and both sexes with malignant spinal bone tumors during the period from 2010 to 2017. The descriptive statistics used were central tendency measures and dispersion in the SPSS v. 22 program from IBM. The results are presented in tables and figures. Results There were 107 patients, 56 (52.34%) men, 51 (47.66%) women with a mean age of 59.75 + 10.76 years (minimum 35, maximum 88). There were 46,840 hospital discharges during the period, for an annual average of 5,855 and a monthly average of 487.91. Of the 107 study cases, 78 (72.89%) were in the lumbosacral, 15 (14.01%) in the cervical, and 14 (13.08%) in the thoracic region. The incidence for the period was 1.9/1000 discharges, 1.38in 2010 increasing to 2.32 in 2017. Conclusions The behavior of primary malignant spinal tumors has increased its presentation from 2010 to 2017 . Level of evidence III; Non-analytical, descriptive study.
DOI: 10.6084/m9.figshare.14288945.v1
title: SPINOPELVIC VARIABILITY ACCORDING TO THE ROUSSOULY CLASSIFICATON CURVE TYPE

description: ABSTRACT Objective To evaluate the variability of spinopelvic sagittal parameters and the distribution of lordosis in the lumbar spine in a sample of patients. Methods This is a cross-sectional study considering full-spine radiographs of a patient sample. The patients were classified according to the Roussouly classification and both radiographic spinopelvic alignment parameters and the lordosis measurement of each lumbar spinal segment were considered. The radiographic parameters were correlated with the Roussouly classification type. Results Ninety patients were included in the study. There was significant correlation between pelvic incidence (PI) and lumbar lordosis (LL) (R=0.89; p&lt;0.0001). The values of PI were significantly higher in Roussouly types 3 and 4 than in types 1 and 2 (p&lt;0.001), as were the values of LL L1-S1(p&lt;0.001). Considering the total sample, 67% of LL L1-S1 was located between L4-S1, but with variations by the Roussouly classification curve types. Conclusion This study demonstrated a high correlation between the values of PI and LL, as well as the importance of the distal lumbar segment (L4-S1) in the overall value of LL L1-S1, which was even higher in patients with a lower PI value (Roussouly types 1 and 2). Level of evidence II; Retrospective analysis of a prospective database (Cohort); Diagnostic study.
DOI: 10.6084/m9.figshare.14288942.v1
title: THE NATURAL HISTORY OF PATIENTS WITH ACUTE DISC HERNIATION: A SERIES OF 150 CASES

description: ABSTRACT Objective This study aims to analyze the characteristics of patients with acute lumbar/sciatic disc herniation who underwent conservative, pain block procedures and surgical treatment, in order to better understand the natural history of herniations and their surgical indications, as well as the impact of hernia volume. Methods We analyzed 150 patients with a diagnosis of acute lumbar disc herniation. The treatments considered were: conservative, infiltration/pain block procedures and microdiscectomy. For seven patients who were surgically treated, the lumbar sequestrectomy volume was submitted to pathological analysis. Results Of the 150 patients, 80% were treated conservatively; 15.31% were treated with pain block procedures and 4.66% underwent microdiscectomy. The mean age of the surgical group was 42.5 years, and 57.1% of the patients were men. Most of the hernias were at L5-S1 (55.5%), and 77.7% were on the left side. All patients had presented significant lumbar pain or sciatica for a long period prior to the surgery. The Lasègue sign was present in all patients. Of the total number of patients, 85.7% presented hypoesthesia and 42.8% presented focal motor deficits, among other findings. The mean hernia volume was 9.6 cm3. Conclusions Unresponsiveness to conservative treatment is an important indication for surgery. The clinical manifestations in patients with a lumbar/sciatic hernia can be very diverse, as can the disc herniation volume, so these are not good indicators for surgery. Level of evidence IV; Case series
DOI: 10.6084/m9.figshare.14288937.v1
title: INFLUENCE OF THE MISDEF ALGORITHM ON THE THERAPEUTIC DECISION FOR VERTEBRAL DEFORMITY IN THE ADULT

description: ABSTRACT Objective The therapeutic decision in cases of adult spinal deformity takes numerous factors into account with a consequent variability in treatment options. The objective is to compare the impact of the MISDEF (minimally invasive spine deformity) algorithm on therapeutic decisions in cases of adult spinal deformity. Methods Prospective radiographic analysis of 40 cases of adult deformity. The cases were sent, in two steps, to 20 Latin American surgeons who had to choose among six treatment options with and without the use of the MISDEF. Results For the conducts of decompression, decompression and short fusion, decompression and fusion with interbody device, and osteotomy with extension of fusion to the thoracic spine, no significant differences were found when comparing decisions made with and without MISDEF. For osteotomy, we observed a tendency for the number of surgeons choosing this conduct to increase when the decision is made with MISDEF. We observed that the number of surgeons who decided on conservative treatment decreased with the use of MISDEF (p &lt;0.001). In cases with sagittal vertical axis &lt;6 cm or pelvic tilt &lt;25 ° or PI-LL (pelvic incidence minus lumbar lordosis) &lt;10 ° or coronal curve &lt;20 °, there was a decrease in the conservative treatment option and an increase in osteotomy with proximal extension of the fusion with the use of MISDEF. Conclusions There is a tendency to increase indications of osteotomy and decrease the conservative treatment option when making a decision with MISDEF. The use of the algorithm showed no significant impact on the therapeutic decision in severe cases of adult deformity. Level of Evidence II; Prospective comparative radiographic analysis.
DOI: 10.6084/m9.figshare.14288936.v1
title: RADIOGRAPHIC EVOLUTION AND CERVICAL SAGITAL BALANCE OF LAMINOPLASTY VERSUS LAMINECTOMY IN PATIENTS WITH CERVICAL SPONDYLOTIC MYELOPATHY

description: ABSTRACT Objective To compare radiographic findings of patients who underwent laminoplasty and laminectomy with arthrodesis for spondylotic cervical myelopathy. Methods Who were submitted to laminectomy with arthrodesis or laminoplasty to treat cervical spondylotic myelopathy with minimum follow-up of 6 months. The radiographic parameters related to the cervical spine evaluated were C0C2 lordosis (C0C2), cervical lordosis (CL), T1 slope (T1S), thoracic inlet angle (TIA), neck tilt (NT), cervical sagittal vertical axis (CSVA), and T1S – CL mismatch (T1S-CL). Results We evaluated 34 patients, 23 (68%) of whom were men. The mean age was 65 years (SD ± 13). There was no statistical difference in any of the preoperative radiographic parameters. Considering the patients submitted to laminectomy alone, a significant difference was observed for C0C2 (P = 0.045), CSVA (P = 0.0008), with differences between IPO and POS times (P = 0.026) and between PRE and POS (P = 0.0013) and T1S – CL mismatch (P = 0.0004), with a difference between IPO and POS (P = 0.0076) and between PRE and POS (P=0.001). Considering the patients submitted to laminoplasty alone, there was no difference over time for any radiographic parameters considered. Comparing the radiographic parameters between the laminectomy and laminoplasty groups in the three time periods, there was no significant difference for any of them. Conclusion This study suggests that patients with cervical spondylotic myelopathy who underwent laminectomy with instrumentation may present worse radiographic evolution as regards cervical sagittal alignment over time when compared to patients who underwent laminoplasty. Level of evidence III; Retrospective case series.
DOI: 10.6084/m9.figshare.14288934.v1
title: T1 PELVIC ANGLE IN IMPROVEMENT OF PAIN IN HIGH-GRADE LUMBAR SPONDYLOLISTHESIS

description: ABSTRACT Objective To evaluate the correlation between global sagittal alignment variables and pain improvement after surgery for High-Grade Spondylolisthesis (HGS). Methods A sample with 20 patients with L5-S1 HGS, submitted to arthrodesis with instrumentation from 01/2004 to 12/2016. Patients’ demographic data, types of surgeries, complications, sagittal alignment parameters, and Visual Analog Scale (VAS) score (ranging from 0 to 4) were recorded before surgery and at the last follow-up. The data were processed in SPSS 22.0. The confidence level was 0.05. Results The majority of the sample were women, 17 (85%); age at surgery: 52.60 ± 17.15 years; mean follow-up: 3.58 ± 1.62 years; isthmic etiology, 16 (80%) and dysplastic, 4 (20%); Meyerding Grading 3: 12 (60%), Grading 4: 3 (15%) and Grading 5: 5 (25%); SDSG type 4: 6 (30%), type 5a: 3 (15%), 5b: 3 (15%), type 6: 7 (35%) and not classified 1 (5%); surgery: in situ fusion 3 (15%) and reduction 17 (85%); fusion levels: L3-S1: 1 (5%), L3-Iliac: 1 (5%), L4-S1: 1 (5%), L4-Iliac: 6 (30%) and L5-S1: 11 (55%). Comparing the pre- and postoperative parameters, a significant improvement (p &lt;0.05) was seen in the VAS, T1 slope, T1 pelvic angle (TPA), slip angle, Dubousset’s lumbosacral angle and slip %. Evaluating the correlation between the variation in sagittal parameters and the improvement in VAS scale, it was found that the TPA showed a strong correlation (r = 0.709, p = 0.032). Conclusions the present study found a strong correlation between the improvement/reduction in TPA values and the reduction in pain intensity in the VAS. Level of evidence IV; Case Series.
DOI: 10.6084/m9.figshare.14288933.v1
title: POSTERIOR VERTEBRAL COLUMN RESECTION IN MULTIPLE LEVELS IN CHILDREN WITH VERTEBRAL TUBERCULOSIS

description: ABSTRACT Objective To evaluate the clinical and radiological results of posterior vertebral column resection in the treatment of kyphosis due to vertebral tuberculosis in children under 9 years of age with neurological deficit. Methods Retrospective study of a series of 5 cases, 4 females and 1 male, mean age of 4.7 years at the time of surgery, with spinal tuberculosis and mean kyphosis of 89 degrees. Results All patients underwent surgical treatment with PVCR in multiple levels, with a mean number of 3.6 resected vertebrae, mean surgical time of 359 minutes, mean postoperative stay of 21.2 days. The mean follow-up was 29 months. The mean kyphosis correction was 62.6%. Before surgery, all patients had signs of spinal cord injury, one of which did not present a deficit of strength or sensibility (ASIA E), but there were pyramidal signs and a history of falls. The other 4 had some degree of sensory-motor dysfunction, with ASIA score varying from A to D. Postoperative complications included two dehiscences of suture, one pneumothorax and one pneumonia, all with favorable evolution. Four patients progressed with neurological improvement and one of them had persistence of the neurological deficit until the last follow-up. Conclusions Multiple-level PVCR has proven to be a safe and effective option for the treatment of kyphotic deformity in spinal tuberculosis in children with neurological deficit. Level of evidence IV; Case Series.
DOI: 10.6084/m9.figshare.14288927.v1
title: GENETIC ASPECTS OF IDIOPATHIC ESCOLIOSIS - A LITERATURE REVIEW

description: ABSTRACT The idiopathic scoliosis (IS) is the most common form of spinal deformity. The pathogenesis of IS is still poorly understood. Several studies show evidence that the genetic component is determinant to the development of IS. In this setting, a crescent focus has been placed on the identification of genes, associated genetic polymorphisms, and multiple susceptibility loci. This review highlights the genes and genetic polymorphisms currently studied, identified as influential in the genesis of IS, such as MMP-3, IL-6, type I collagen, and vitamin D and estrogen receptors. We concluded that IS remains a complex disease with a polygenic background and that genetic polymorphisms are intrinsically related to this condition. Level of evidence III; Narrative Review.
DOI: 10.6084/m9.figshare.14288925.v1
title: PREOPERATIVE HALO-GRAVITY TRACTION WITH AND WITHOUT ANTERIOR RELEASE FOR SEVERE SCOLIOSIS

description: ABSTRACT Objective: This study aims to compare the use of halo-gravity traction (HGT) with and without previous anterior release, in terms of curve reduction, for the treatment of pediatric severe spinal deformity. Methods: From 2010 to 2016, all patients treated with HGT prior to instrumentation for scoliosis and kyphoscoliosis were reviewed. They were assessed by deformity etiology, previous anterior release, instrumentation procedure used, traction protocol, major Cobb angle before traction, after the protocol, and after the instrumentation procedure. Twelve patients met these criteria and constituted the sample groups: Group I (n=7) with anterior release and Group II (n=5) without anterior release. Results: The average pre-traction major curve Cobb angles were 114.9o and 108.4º for Group I and II, respectively (P&gt;0.05). After HGT, both groups achieved a significant reduction in curve angle (P&lt;0.05). Group I presented an average Cobb angle of 95.0o after HGT, representing a 17.3% (19.8o) curve reduction. Group II presented a Cobb angle of 80.1o, representing a 25.2% (28.4o) curve reduction. The difference between the two groups in relation to the reduction of major curve after HGT was not statistically significant (P=0.073). After the surgical procedure, the correction achieved was significantly improved (P&lt;0.05), without statistically significant difference between the two groups (P&gt;0.05). No major HGT related complications were reported. Conclusions: Anterior release prior to HGT did not increase major curve correction after posterior surgery for severe pediatric idiopathic and syndromic scoliosis. HGT is an effective and safe technique, though it frequently presents minor and transitory complications. Level of Evidence III; Retrospective Comparative Study.
DOI: 10.6084/m9.figshare.14288924.v1
title: GAUCHER DISEASE TYPE 1 IN THE SKELETON: REVIEW OF LATIN AMERICA

description: ABSTRACT Gaucher disease (GD) is the most prevalent lysosomal storage disease, and is characterized by the accumulation of glucosylceramide and glucosylsphingosine in tissues throughout the body. With the advent of enzyme replacement therapy, the prognosis for patients with GD has dramatically improved. Still, the skeletal manifestations associated with GD respond slowly to enzyme replacement therapy and are the most significant contributor of disease related patient morbidity. This review of bone manifestations in GD presents the most recent theories on its pathophysiology, and gives a systematic review of studies with Latin American patients that report the frequency of bone manifestations and the effects of enzyme replacement therapy on their treatment. We conclude by emphasizing the importance of early identification and proper management at appropriate dosage levels of enzyme replacement therapy to reduce the morbidity caused by GD.
DOI: 10.6084/m9.figshare.14288921.v1
title: TOMOGRAPHIC ANALYSIS OF SUBAXIAL CERVICAL VERTEBRAE IN CHILDREN BETWEEN 0 AND 12 YEARS

description: ABSTRACT Objective: Tomographic and anatomic analysis of cervical vertebrae in children from 0 to 12 years of age to verify the possibility of utilization of lateral mass screws. Methods: Twenty-five cervical spine tomographies of children between 0 and 12 years of age, admitted to the emergency room of Hospital das Clínicas of São Paulo were retrospectively analyzed. The following distances were measured: width and length of the lateral masses in the axial section; width and height in the coronal section; height, length and diagonal diameter in the sagittal section. The variables studied were correlated with age and sex and submitted to statistical analysis. Results: The analysis of tomographic measurements of 20 patients showed a correlation between age and dimensions of the lateral mass, which were higher after 6 years of age. In relation to sex, greater measures were observed in males in all axes. With regard to the passage of the screws, we only had 22 masses (11%) that prevented their use. However, when stratified by age, we noticed that no patients had restrictions on the use of the lateral mass screw after the age of 6. Conclusion: This study analyzed the measurements of 200 lateral masses, making it possible to infer that there is an increase of dimensions with age and in males. Through the data, it was possible to affirm that in this sample, considering the implants available in the market, the lateral mass screws could be used in 89% of the lateral masses.
DOI: 10.6084/m9.figshare.14288920.v1
title: RADIOGRAPHIC ALIGNMENT OF CERVICAL SPINE ON A SAMPLE OF ASYMPTOMATIC SUBJECTS

description: ABSTRACT Objective: To present normality parameters for the cervical spine in a sample of the Brazilian population and its distribution by sex and age. Methods: This was a prospective study considering 94 asymptomatic individuals evaluated by panoramic radiograph of the spine for the analysis of the following parameters: cervical lordosis (CL), C2 sagittal vertical axis (SVA-C2), cervical sagittal vertical axis (cSVA), and T1 Slope (TA-T1). The parameter values were compared according to sex and age of individuals. Results: The mean CL was -16.5° (SD: ± 10.8°), SVA-C2 was -3.9 mm (SD: ± 29.2 mm), cSVA was 16.9 mm (SD: ± 10.6 mm) and TA-T1 was 24.8° (SD: ± 7.0°). There was no significant difference between the radiographic parameters when considered with respect to sex and age of individuals (P&gt;0.05). The analysis of correlation among the radiographic parameters showed that the TA-T1 presented the highest correlation with the other parameters, including CL (r= 0.367, P&lt;0.01), SVA-C2 (r= 0.434, P&lt;0.001) and cSVA (r= 0.441, P&lt;0.001). There was also a correlation between SVA-C2 and cSVA (r= 0.32, P= 0.001) and inverse correlation between CL and the cSVA (r= -0.242, P= 0.019). Conclusio: We introduced normality data of the cervical spine alignment in a Brazilian population sample. There was significant correlation among the analyzed parameters, especially considering TA-T1 in relation to the other parameters.
DOI: 10.6084/m9.figshare.14288919.v1
title: OVERLOAD STUDY ON ADJACENT DISC AFTER ARTHRODESIS IN THORACOLUMBAR FRACTURES

description: ABSTRACT Objective: To analyze the degeneration of the adjacent disc after arthrodesis due to thoracolumbar fractures. Methods: Eighty-three patients who underwent posterolateral arthrodesis in thoracolumbar levels had their x-rays analyzed for degeneration of adjacent discs to the arthrodesis. The disc spaces were classified by the UCLA scale. Results: Of the 83 patients evaluated, 66 were males (79%) and 18 females (21%), with a mean age of 35.5 years. The mean follow-up period was 40 months. As the fractures 75% were between T12 and L2 (p&lt;0.001), being of the A3 type in 65% of the cases (p&lt;0.001). The most common mechanism of injury, accounting for 50% of the cases (p&lt;0.001), was fall from height. Only 6% of the superior discs and 12% of the inferior ones showed some degree of degeneration. No patient underwent a new surgical approach. Conclusion: The incidence of degeneration on adjacent disc in patients after arthrodesis resulting from fractures ranged from 6% to 12% with an average follow-up of 40 months.
DOI: 10.6084/m9.figshare.14288918.v1
title: EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH TRAUMATIC SPINAL FRACTURE

description: ABSTRACT Objective: To analyze the epidemiological profile of patients with spinal fractures and the characteristics of the population at risk attended at a university hospital. Methods: The study population is composed of 202 patients diagnosed and treated for vertebral fracture due to trauma. The variables were correlated with each other and the correlations with p&lt;0.05 were considered statistically significant. Results: The ratio of incidence of trauma between the sexes was 3:1 for males. The mean age was 37 years and the age group with the highest incidence was between 20 and 39 years. Traffic accidents were the most frequent mechanism (51.2%) and secondly, falls (33.2%). There was a statistical correlation between trauma mechanisms to age group and region of the spine. The first lumbar vertebra (L1) fracture alone accounted for 21.5% of all cases studied associated with the fall mechanism. Spinal cord injury was recorded in 33.7% of the individuals in the sample. A total of 57.3% of the patients were submitted to surgical treatment and 41.7% to the conservative treatment. The mean hospitalization time was 15 days. Conclusions: Spinal fractures are important determinants of morbidity and mortality in the population with a major impact on economically active individuals, especially males. They are directly associated to traffic accidents in the young population and to falls in the higher age brackets. Primary prevention of trauma is the main mechanism for change in this scenario.
DOI: 10.6084/m9.figshare.14288916.v1
title: EVALUATION OF FACET, SACRAL AND FORAMINAL INFILTRATIONS IN THE TREATMENT OF LOW BACK PAIN

description: ABSTRACT Objective: The difficulties of the study and the lumbago approach stem from several factors, among them, the lack of a reliable correlation between the clinical findings and image results and the fact the lumbar segment is innervated by a network of diffuse and intertwined nerves, making it difficult to accurately determine the location of pain origin. The treatment of this disease is mainly based on conservative measures (rest, analgesia, physical therapy) and only in a few cases, the option is surgical measures. Methods: In this study, we conducted an analysis of the results obtained with foraminal, sacral and facet infiltrations of corticoids in the lumbosacral spine in a period of three months in 83 patients with low back pain. Results: The patients showed a statistically significant reduction of pain (mean value) after infiltrations (sacral, foraminal and facet), according to the Visual Analogue Scale of 4 points in the immediate postoperative period, reduction of 3.9 points at 15 days, reduction of 3.5 points at 30 days, a reduction of 3.1 points at 45 days and a reduction of 2.7 points at 90 days. Conclusion: The sacral, foraminal and facet infiltrations of corticoids to control low back pain relieves short-term pain (30 days) and medium and long-term (30-90 days), when the indication is correct.