cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.14288914.v1
title: THORACIC DISC HERNIATION: CASE SERIES AND PROTOCOL FOR SURGICAL APPROACHES

description: ABSTRACT Objective To describe the surgical results of a prospective series of five patients operated according to an approach indication protocol. Methods: Patients were classified according to surgical risk: Group A (high risk) or B (low risk) and subsequently into subgroups according to characteristics of the herniation and ultimately the surgical approach was defined: A.1) calcified central herniations - thoracoscopy; A.2) soft lateral herniations - posterolateral approach; A.3) centrolateral herniations - partial calcification in lateral position - posterolateral approach; higher density central calcification - thoracoscopy; B.1) central or centrolateral calcified herniations - thoracotomy or thoracoscopy; B.2) soft lateral herniations - posterolateral approach. Results: The duration of symptoms ranged from 2 months to 3 years; the age bracket was from 37 to 58 years; sex distribution was 3 female and 2 male patients and the length of hospital stay ranged from 2 to 20 days. The most affected level was T11/12. A patient classified as Group A.3 underwent posterolateral approach. The remaining patients were Group B.1, 3 submitted to thoracotomy and 1 to thoracoscopy. The herniation removal was completed in 5 cases; 3 patients improved and 2 remained stable. The morbidity and the recovery time were higher in patients who underwent anterolateral approaches. Conclusions: Classify patients according to surgical risk and the anatomical characteristics of disc herniation allows for complete decompression, minimizing morbidity and mortality.
DOI: 10.6084/m9.figshare.14288913.v1
title: TREATMENT OF THORACOLUMBAR MULTIPLE FRACTURES WITH MINIMALLY INVASIVE SURGERY

description: ABSTRACT Objective: To demonstrate that the extrapedicular unilateral percutaneous treatment in multiple thoracolumbar fractures is effective, minimally invasive and can treat several vertebrae at the same time in the same surgery. Method: From January 2007 to January 2015 306 patients with multiple vertebral fractures in the thoracolumbar junction of various etiologies were treated, of which 246 were women and 60 men. Results: The extrapedicular unilateral treatment shows good clinical results that are maintained over time, is performed on an outpatient basis with minimal complications, and enables rapid incorporation of patients to their daily activities. Conclusions: Our study shows that unilateral extrapedicular percutaneous kyphoplasty is an effective treatment for multiple thoracolumbar vertebral fractures. This method makes the procedure less invasive, allowing multiple levels are treated in the same surgical intervention, resulting in relief of pain and stability of the spine, minimal complications and immediate return of the patient to daily activities.
DOI: 10.6084/m9.figshare.14288910.v1
title: GUILLAIN-BARRE SYNDROME AS A DIFFERENTIAL DIAGNOSIS OF LOW BACK PAIN SYNDROME

description: ABSTRACT Peripheral neuropathies are diseases of the lower motor neurons of the spinal cord and brainstem it can often mimic symptoms associated with the injuries of compressive radiculopathy. They are manifested by tingling, coldness, numbness, burning, pain, hypersensitivity, weakness, atrophy, postural hypotension, impotence, anhidrosis, and urinary incontinence. Therefore, it is important in the diagnostic strategy to keep in mind this type of pathology, especially when it comes to patients already in the 6th decade of life.
DOI: 10.6084/m9.figshare.14288908.v1
title: LEVEL OF EVIDENCE IN THE PLACEMENT OF TRANSPEDICULAR SCREWS IN SUBAXIAL CERVICAL SPINE

description: ABSTRACT The high-energy trauma mainly involves vertebral lesions and 6% occur in the cervical region. This poses a challenge to spine surgeons in surgical decision-making, both in terms of approach as the instrumentation. International recommendations establish that the procedures performed are reproducible, safe, and effective. The techniques for placement of pedicle screws are complicated and have been based on intraoperative navigation (limited by cost) and fluoroscopy (greater exposure of health care professionals and patients to radiation). Therefore, the freehand technique is an option. The goal was to identify the level of evidence and grade of recommendation in the medical literature regarding the safety and efficacy of pedicle screw instrumentation with freehand technique in subaxial cervical spine. To this end, we carried out a systematic review with the following MeSH terms: safety, efficacy, vertebral artery. Articles were evaluated twice in a standardized and blind way by two observers skilled in systematic analysis, after CLEIS 3401 authorization in November 2014. Due to the nature of the study and the variables, articles with a high level of evidence and grade of recommendation were not found. Level of Evidence obtained on safety and efficacy in the placement of pedicle screws in subaxial column with freehand technique: 2b. Degree of Recommendation obtained on safety and efficacy in the placement of pedicle screws in subaxial column with freehand technique: B, favorable recommendation.
DOI: 10.6084/m9.figshare.14288906.v1
title: CORRELATION BETWEEN QUALITY OF LIFE AND OSTEOLYSIS AROUND LUMBAR PEDICLE SCREWS

description: ABSTRACT Objective: To evaluate whether the presence of osteolysis around the pedicle screws affects the quality of life of patients who underwent posterolateral arthrodesis of the lumbosacral spine. Methods: A retrospective study of patients undergoing lumbar posterolateral or lumbosacral arthrodesis due to spinal degenerative disease. CT scans of the operated segments were performed at intervals of 45, 90, 180, and 360 postoperatively. In these tests, the presence of a peri-implant radiolucent halo was investigated, which was considered present when greater than 1mm in the coronal section. Concurrently with the completion of CT scans, the participants completed the questionnaire Oswestry Disability Index (ODI) to assess the degree of disability of the patients. Results: A total of 38 patients were evaluated, and 14 (36.84%) of them showed some degree of osteolysis around at least one pedicle screw at the end of follow-up. Of the 242 analyzed screws, 27 (11.15%) had osteolysis in the CT coronal section, with the majority of these occurrences located at the most distal level segment of the arthrodesis. There was no correlation between the presence of the osteolysis to the quality of life of patients. The quality of life has significantly improved when comparing the preoperative results with the postoperative results at different times of application of ODI. This improvement in ODI maintains linearity over time. Conclusion: There is no correlation between the presence of peri-implant osteolysis to the quality of life of patients undergoing lumbar or posterolateral lumbosacral arthrodesis in the follow-up period up to 360 days. The quality of life in postoperative has significantly improvement when compared to the preoperative period.
DOI: 10.6084/m9.figshare.14288903.v1
title: RETROSPECTIVE COMPARATIVE ANALYSIS OF SURGICAL TREATMENT OF THORACOLUMBAR BURST FRACTURE: SHORT VERSUS LONG FIXATION

description: ABSTRACT Objective: The objective of this study is to compare short posterior fixation to long posterior fixation in thoracolumbar burst fractures. Methods: Fifty-three patients were divided into Group I (n=24) treated with short instrumentation (one level above and one below the fracture) and into Group II (n=29) treated with long instrumentation (two or more levels above and below the fracture). The load sharing classification was used to stratify cases. The evaluation of the sagittal index was performed using the Cobb method. Results: In subgroups with load sharing classification ≤ 6, Group I had loss of correction of 4.2 degrees and a procedure failure in 14.3% of cases, Group II showed loss of correction of 5.4 degrees and failure in 21.7% of cases. In subgroups with load sharing classification ≥7, Group I had a loss of correction of 11.2 degrees and procedure failure in 70% of cases, and Group II showed a loss of correction of 9 degrees and failure of 46.7%. Group I had a tendency to worse outcomes, especially in the subgroup of patients with load sharing classification ≥7. Conclusion: Despite the tendency for poorer results in the short fixation group in the cases with load sharing ≥7, in no sample was there statistically significant difference between the groups studied.
DOI: 10.6084/m9.figshare.14288900.v1
title: RESULTS OF SURGICAL TREATMENT IN THE CRANIOCERVICAL JUNCTION IN MUCOPOLYSACCHARIDOSIS

description: ABSTRACT Objective: Evaluate the results after decompression and stabilization of craniocervical junction in patients with mucopolysaccharidosis (MPS). Method: Retrospective study of 10 patients with MPS through the analysis of medical records and additional tests. Result: All patients with mid-term and long-term follow-up achieved consolidation of the arthrodesis and 87.5% had neurological improvement of Nurick score. Conclusion: Early diagnosis and intervention in cases of stenosis and/or craniocervical instability of patients with MPS provide patients a good recovery of neurological function, despite the great technical difficulty and risk of complications.
DOI: 10.6084/m9.figshare.14288892.v1
title: RESULTS OF THE USE OF PEEK CAGES IN THE TREATMENT OF BASILAR INVAGINATION BY GOEL TECHNIQUE

description: ABSTRACT Objective: Analysis of the use of polyetheretherketone (PEEK) cages for atlantoaxial facet realignment and distraction for treatment of basilar invagination by Goel technique. Method: Retrospective descriptive statistical analysis of the neurological status, pain, presence of subsidence and bone fusion with the use of PEEK cages in 8 atlantoaxial joints of 4 patients with basilar invagination. All patients were treated with atlantoaxial facet distraction and realignment and subsequent arthrodesis C1-C2 by the technique of Goel modified by the use of PEEK cage. Results: All patients showed improvement in Nurick neurological assessment scale and Visual Analogue Scale (VAS) of pain. There were no cases of subsidence, migration, or damage to the vertebral artery during the insertion of the cage. All joints evolved with bone fusion, assessed by dynamic radiographs, and computed tomography. Two patients developed neuropathic pain in dermatome of C2 and one patient had unilateral vertebral artery injury during C2 instrumentation treated with insertion of pedicle screw to control the bleeding. Conclusion: The results of the treatment of basilar invagination by the Goel technique with the use of PEEK cages shown to be effective and safe although further studies are needed to confirm this use.
DOI: 10.6084/m9.figshare.14288891.v1
title: EPIDEMIOLOGY OF SPINE FRACTURES IN MOTORCYCLE ACCIDENT VICTIMS

description: ABSTRACT Objective: To analyze the incidence of spinal injuries between 2000-2010 due to motorcycle accidents and the relation to the increase in motorcycle sales in the same period, as well as the anatomical distribution of these spinal injuries. Methods: Data were collected from 1,295 records of patients who have suffered spinal injury resulting from motorcycle accidents admitted to the ward TRM (Spinal Cord Trauma) of the Hospital Geral do Estado da Bahia from 2000 to 2010 in this retrospective study. We selected 110 medical records and collected information on sex, age, neurological deficit on admission (according to Frankel scale), diagnosis, and level of injury. Results: Between 2000 and 2010 there was an increase of almost five times in the incidence of patients who have suffered spinal injury due to motorcycle accidents. More than half (51.4%) had cervical spine injury, 37.2% thoracic spine injury and 11.34% had lumbar spine injury. Only 34.3% of patients had no neurological deficit on admission and patients with thoracic spine fracture had a higher incidence and severity of lesion. The average age of patients was 30 years. Conclusions: The increased incidence of spinal injuries due motorcycle accidents occurred in the same period in which there was an increase in motorcycle sales in the country. Patients who have suffered those injuries were young, with higher incidence in the cervical and thoracic spinal levels and high rates of neurological deficit.
DOI: 10.6084/m9.figshare.14288888.v1
title: SPINAL CORD TRAUMA PATIENTS TREATED IN A TERTIARY HOSPITAL IN PALMAS, BRAZIL

description: Objective:Traumatic spinal cord injury is one of the leading causes of disability worldwide, mainly related to automobile accidents. It was decided to establish a clinical-epidemiological profile of spinal cord injury (SCI) in Palmas, Brazil.Method:Prospective study at the Public General Hospital of Palmas (HGPP), including all patients admitted in this hospital from January 2011 to February 2012.Results:They refer to 59 patients, of whom 81.4% were men and 47.4% of the victims had up to 40 years. The main mechanism of injury was motor vehicle accidents involving motorcycles. Clinically, the vertebral segment C4-C7 was the most damaged, and most patients were admitted with spinal injury and no neurological deficit (Frankel E).Conclusions:Primary involvement of young men in working age, trauma mainly due to car accidents that are usually associated with the use of alcoholic beverages. Patients admitted with more severe neurological deficits have evolved to milder impairments after conservative or surgical treatment.
DOI: 10.6084/m9.figshare.14288882.v1
title: SUBAXIAL CERVICAL FRACTURE: APPLICATION AND CORRELATION OF AO AND SLIC

description: Objective:To evaluate the AO/Magerl classification and the SLIC (Subaxial Cervical Spine Injury Classification), used in the cervical spine fractures and assess whether they are correlated to the neurological severity of patients, the choice of approach to be used, de duration of surgery an between themselves.Method:Retrospective analysis of medical records and radiological image files of 77 patients surgically treated of subaxial cervical fracture or dislocation from August 2010 to September 2012.Results:The SLIC classification showed a strong correlation with neurological deficit and Pearson correlation value of -0.600. The AO classification was not correlated with the Frankel scale and the value of Pearson was 0.06 with a statistical significance of 0.682 (p&lt;0.05), that is, unable to determine or suggest the severity of the deficit. When compared to each other the two classifications showed statistical correlation and the value of Pearson was 0.282 with a significance value of 0.022 (p&lt;0.05).Conclusion:Among the most used classifications, the SLIC has been able to statistically define the need for surgical treatment and the severity of the neurological status, but was unable to predict the approach or the time of the surgery; the classification AO failed to predict the severity of neurological injury, surgical time, and did not help to choose the approach, just being a morphological classification.
DOI: 10.6084/m9.figshare.14288880.v1
title: CORRELATION BETWEEN OBESITY, SAGITTAL BALANCE AND CLINICAL OUTCOME IN SPINAL FUSION

description: Objective:To correlate obesity with radiographic parameters of spinal and spinopelvic balance in patients undergoing spinal arthrodesis, and to correlate obesity with clinical outcome of these patients.Methods:Observational retrospective study including patients who underwent spinal arthrodesis, with minimum follow-up period of three months. We measured waist circumference, as well as height and weight to calculate body mass index (BMI) and obtained radiographs of the total column. The clinical parameters studied were pain by visual analog scale (VAS) and the Oswestry questionnaire (ODI). Obesity correlated with radiographic parameters of the sagittal and spinopelvic balance and postoperative clinical parameters.Results:32 patients were analyzed. The higher the BMI, the greater the value of VAS found, but without statistical significance (p=0.83). There was also no correlation between BMI and the ODI questionnaire. Analyzing the abdominal circumference, there was no correlation between the VAS and ODI. There was no correlation between BMI or waist circumference and the radiographic parameters of global spinopelvic sagittal alignment. Regarding the postoperative results, there was no correlation between the mean BMI and waist circumference and the postoperative results for ODI and VAS (p=0.75 and p=0.7, respectively).Conclusions:The clinical outcomes of patients who undergone spinal fusion were not affected by the BMI and waist circumference. Also, there was no correlation between radiographic parameters of spinal and spinopelvic sagittal balance with obesity in patients previously treated with arthrodesis of the spine.
DOI: 10.6084/m9.figshare.14288879.v1
title: SURGICAL VS. CONSERVATIVE TREATMENT FOR DEGENERATIVE LUMBAR STENOSIS

description: Objectives:To compare the clinical outcomes between patients with degenerative lumbar stenosis who were treated by decompression with those awaiting the same kind of treatment for the disease.Methods:Retrospective study which divided patients with degenerative lumbar stenosis with surgical indication in 2 groups, operated and awaiting the procedure. The Oswestry Disability Index (ODI) questionnaire, visual analog scale and SF36 were applied.Results:Twelve operated patients and 18 awaiting the procedure were included. The average age of those operated was 59 years (43-70), and 55 (37-82) (p=0.3) for those awaiting surgery. The operated group had a mean ODI of 38.67 against 59.72 (p&lt;0.05) in the non-operated group. The pain analog scale had lumbar result of 5.33 and pain radiating to the lower limbs of 3.83 in operated patients, against 6.78 (p&gt;0.05) and 7.22 (p&lt;0.05) in the awaiting surgery patients, respectively. As for the SF36 scale, functional capacity, limitations due to physical aspects and pain had an average score of 36.25, 19.58 and 21.67 in the operated group against 35.94, 27.50 and 32.61 in the awaiting group (p&gt;0.05), respectively.Conclusion:The operated patients showed improvement of referred pain in the lower limbs (leg VAS) and improved function (Oswestry), however showed no significant change in quality of life according to SF36 scale and low back pain (lumbar VAS) were found.
DOI: 10.6084/m9.figshare.14288877.v1
title: STANDARDIZED TERMINOLOGY OF ADULT SPINE DEFORMITY FOR BRAZILIAN PORTUGUESE

description: Objective : To develop a consensus for translation of the most relevant terms used in the study of Adult Spinal Deformity, from their original languages into Brazilian Portuguese. Methods : A panel of 12 experts in spine surgery from the five Brazilian regions was constituted. To obtain the standardization of terminology, the Delphi method with an electronic questionnaire was administered to participants about their opinion on the translation of 13 relevant terms chosen by literature review. Each term was considered standard when there was consensus, that is, concordance higher than 80% among participants as to the suggestion to be adopted, and then on the acceptance of the term and its abbreviation in Portuguese. Results : Initially there was consensus (over 80% concordance) on the translation of seven terms in the electronic questionnaire. The other six terms that have not reached consensus were discussed at a meeting among the participants, relying on the opinion of a specialized professional in simultaneous translation of orthopedic terms in Portuguese and other professional majored in Portuguese language. It was decided how these terms should be translated and there was a consensus among all participants regarding their acceptance. Finally, there was consensus among the participants, who agreed with the translation and abbreviation of the 13 propose terms, defining its standardization for Brazilian Portuguese. Conclusion : We present a standard terminology used in the study of Adult Spinal Deformity through consensus among experts, seeking uniformity in the use of these terms in Brazilian Portuguese.
DOI: 10.6084/m9.figshare.14288876.v1
title: Adjacent segment disease in degenerative pathologies with posterior instrumentation

description: OBJECTIVE: To establish the real incidence of adjacent segment disease after fusion, and to identify the levels and predisposing factors for the pathology, as well as the functional results. METHODS: a retrospective case series study with level of evidence IIB, in a sample of 179 patients diagnosed with stenosis of the lumbar spine, spondylolisthesis and degenerative scoliosis, submitted to surgery in the period 2005 to December 2013, with posterior instrumentation and posterolateral fusion, with follow-up from 2007 until May 2014, in which the symptomology and radiographic findings were evaluated, to establish the diagnosis and treatment. RESULTS: the study included 179 patients diagnosed with stenosis of the lumbar spine (n=116), isthmic and degenerative spondylolisthesis (n=50) and degenerative scoliosis (n=13); during the study, 20 cases of adjacent level segment were identified, 80% of which were treated surgically with extension of the instrumentation, while 20% were treated conservatively with NSAIDs and therapeutic blocks. CONCLUSION: An incidence of 11% was found, with an average of 3.25 years in diagnosis and treatment, a prevalence of females and diagnosis of stenosis of the lumbar canal on posterior instrumentation, a predominance of levels L4-L5; 80% were treated with extension of the instrumentation. The complications were persistent radiculopathy, infection of the surgical wound, and one death due to causes not related to the lumbar pathology.
DOI: 10.6084/m9.figshare.14288874.v1
title: Clinical evaluation of patients undergoing dynamic pedicle fixation in lumbar spine

description: OBJECTIVE: To evaluate the preliminary clinical results and complications in patients undergoing dynamic pedicle fixation of the spine in the treatment of a specific group of degenerative lumbar disease.METHODS: In this preliminary retrospective study, we selected 14 patients who underwent surgery from January 2006 to July 2010. We selected only patients with spondylolisthesis without spondylolysis (Grade 1 Meyerding). All patients underwent surgery at one level and the levels mostly addressed were: L3-L4, L4-L5 or L5-S1. The approach was the same in all patients (posterior median approach with preservation of the posterior elements). All patients underwent intense conservative treatment without clinical response and the same research algorithm preoperatively.RESULTS: Retrospective analysis of Oswestry questionnaire after selection and publication of results of 14 patients with Grade 1 spondylolisthesis who underwent dynamic pedicle stabilization in a total of 56 pedicle screws, being all in one level. There was no fracture of any screws, the mean hospital stay was a day and a half, no patient required blood transfusion and there were no cases of infection, with significant improvement in the Oswestry questionnaire.CONCLUSION: In this study, the dynamic pedicle stabilization method proved to be an excellent treatment option when surgical criteria are strictly adhered to. There was an improvement in Oswestry values, lower hospital stay and low rate of complications, consisting of an alternative in motion preservation surgery.