Délio Eulálio Martins

Hospital Israelita Albert Einstein

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Marcelo Wajchenberg

Hospital Israelita Albert Einstein

Eduardo Barros Puertas

Universidade Federal de São Paulo

Michel Kanas

Hospital Israelita Albert Einstein

Nelson Astur

Hospital Israelita Albert Einstein

David Del Curto

Universidade Federal de São Paulo

Renato Hiroshi Salvioni Ueta

Universidade Federal de São Paulo

Mário Lenza

Hospital Israelita Albert Einstein

Alberto Ofenhejm Gotfryd

Hospital Israelita Albert Einstein

Rafael Paiva Luciano

Universidade Federal de São Paulo

Marcio Squassoni Leite

Universidade Federal de São Paulo

Cooperative Institutions

Universidade Federal de São Paulo

Hospital Israelita Albert Einstein

Universidade de São Paulo

Anhembi Morumbi University

Fundação de Apoio à Universidade Federal de São Paulo

Hospital São Paulo

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Associação Paulista de Medicina

Union des Industries Ferroviaires Européennes

Irmandade da Santa Casa de Misericórdia de São Paulo

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Estudo comparativo do arco de movimento da coluna lombar em indivíduos praticantes e não praticantes de esporte

Revista Brasileira de Ortopedia (2010)

Carla Chertman Humberto Maldonado Campoy dos Santos Leonardo Aboim Pires Marcelo Wajchenberg Délio Eulálio Martins

OBJETIVO: Comparar a amplitude de flexão e de extensão de tronco por meio de goniometria em atletas e não atletas, relacionando estes dados com o teste do ângulo poplíteo e dos músculos isquiotibiais. MÉTODOS: A amplitude de flexão e extensão de tronco foi avaliada em 50 indivíduos praticantes de esporte regularmente e 50 indivíduos não atletas, os quais não apresentavam nenhum tipo de sintomatologia dolorosa lombar, bem como algum sintoma que pudesse influenciar a realização dos testes. As mensurações foram realizadas por dois examinadores independentes consecutivamente por meio de goniometria. Os valores de flexão e extensão de tronco obtidos pela avaliação da goniometria foram correlacionados com o teste do ângulo poplíteo e de flexibilidade dos isquiotibiais, analisando-se a correlação estatística entre os mesmos. RESULTADOS: Os valores médios obtidos foram 130,7 (101,9) para flexão e 40,2 (36,4) para extensão. Verificou-se diferença estatisticamente significante entre o grupo de atletas e não atletas em relação aos parâmetros: goniômetro em flexão com o avaliador 1, goniômetro em flexão com o avaliador 2 e teste dos isquiotibiais. Não foi verificada diferença estatisticamente significante entre o grupo de atletas e não atletas em relação aos parâmetros: goniômetro em extensão com o avaliador 1, goniômetro em extensão com avaliador 2 e teste do ângulo poplíteo. CONCLUSÃO: Observa-se que a flexão do tronco apresenta valores mais elevados em indivíduos praticantes de esporte. A utilização de goniometria para mensuração de amplitude de tronco indicou valores variáveis entre os examinadores.

10.1590/s0102-36162010000400008

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Citations (10)

Bacterial identification in herniated intervertebral discs: a prospective cohort study

The Spine Journal (2024)

Nelson Astur Délio Eulálio Martins Michel Kanas André Mario Doi Marinês Dalla Valle Martino

Identification

Intervertebral Disc

10.1016/j.spinee.2024.05.015

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Citations (1)

Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar Correlation between Pfirrmann and Modic classifications in the degeneration of lumbar intervertebral disc Correspondencia entre las clasificaciones de Pfirrmann y Modic en la degeneración del disco intervertebral lumbar

Marcio Squassoni Leite Rafael Paiva Luciano Délio Eulálio Martins Marcelo Wajchenberg Eduardo Barros Puertas

Objective: to correlate the changes found in the lumbar magnetic resonance imaging according to Modic and Pfirrmann classifications. Methods: lumbar spine resonances of 54 outpatients were selected (23 men and 31 women), who were already under investigation because of their comorbidity. According to their degree of Pfirrmann classification, 264 intervertebral discs (L1 to S1) were classified. The presence of signal abnormalities of the vertebral body was recorded as Modic classification. The χ 2 was applied, adopting significance levels below 0.05 (a=5%). Results: The mean age studied was of 48.4 years (26-77 years). A higher prevalence of Pfirrmann type IV (31.1%) was observed. In 88.3% of the sample, Modic was absent, and also Modic 3; 60% of Modic 2 was related to Pfirrmann type V, and 36.4% of Modic

Modic changes

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Cisto aracnóide após trauma na coluna torácica com compressão medular: Relato de caso

Revista Brasileira de Ortopedia (2020)

Igor de Barcellos Zanon Michel Kanas Marcos Augusto Stávale Joaquim Délio Eulálio Martins Marcelo Wajchenberg

Resumo Cistos aracnóides são raros, podem ocorrer em todos os níveis do saco dural, e sua origem pode ser congênita, traumática, iatrogênica ou inflamatória. Neste artigo, relatamos o caso de uma paciente com mielopatia torácica compressiva decorrente de um cisto aracnóide intradural incomum, de manifestação pós-traumática, assim como sua resolução, além de realizar revisão da literatura sobre o tema. A principal localização é na coluna torácica, seguida das colunas lombar, lombossacra e toracolombar. O cisto com origem traumática é causado por lesão da camada interna da dura-máter. Essas lesões produzem déficit neurológico por meio de efeito de massa sobre a medula espinhal. A existência de mielopatia compressiva associada é mais rara ainda. A ressecção ou drenagem dos cistos na vigência de mielopatia deve ser imediata, sendo o tratamento de escolha. Apesar de raros, podem ser uma complicação de fraturas da coluna vertebral que são muito comuns na prática de ortopedistas e neurocirurgiões, que devem estar preparados para essa situação incomum.

10.1055/s-0040-1714225

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Association between vitamin D serum levels and adolescent idiopathic scoliosis

Scoliosis (2014)

Rodrigo Batista Délio Eulálio Martins Lilian Fukusima Hayashi Marise Lazaretti‐Castro Eduardo Barros Puertas

Background Idiopathic scoliosis (IS) is a deformity of the spine that occurs in up to 4% of children during childhood and adolescence. Idiopathic scoliosis is considered multifactorial, and family history may present several individuals affected. We still cannot determine which curves will worsen and at what rate, but some factors, such as age, growth potential and skeletal maturity have been associated with a higher risk of progression. Studies have suggested that a decrease in bone mineral density may be responsible for the appearance and progression of the disease, and some have tried to link vitamin D receptor gene (VDRG) polymorphism to adolescent idiopathic scoliosis (AIS).

Idiopathic scoliosis

10.1186/1748-7161-9-s1-o45

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Citations (22)

Changes in human intervertebral disc biochemical composition and bony end plates between middle and old age

PLoS ONE (2018)

Délio Eulálio Martins Valquíria P. Medeiros Marcelo Wajchenberg Edgar Julian Paredes‐Gamero Marcelo A. Lima

Objective This study evaluates molecular, nutritional and biochemical alterations in human intervertebral discs between middle and old age. Methods Twenty-eight human lumbar intervertebral discs from donors were evaluated and separated into two groups: Middle-aged (35–50 years old, relatively non-degenerate discs of Pfirrmann grades 1–3, n = 15) and Old-aged (≥80 years old, all degenerate Pfirrmann grade 4 or 5, n = 13). Parameters which might be expected to to be related to nutrient supply and so the health of disc cells (eg the porosity of the vertebral endplate, cell viability and cell density) and to disc extracellular composition (ie quantification of glycosaminoglycan disaccharides and hyaluronic acid molecular weight) and collagen organization, were analyzed. Three regions of the intervertebral disc (anterior annulus fibrosus, nucleus pulposus, and posterior annulus fibrosus) were examined. Results The old-aged group showed a decrease in content of sulphated and non-sulphated glycosaminoglycans relative to middle-aged and there were also alterations in the proportion of GAG disaccharides and a decrease of collagen fiber size. Hyaluronic acid molecular weight was around 200 kDa in all regions and ages studied. The anterior annulus differed from the posterior annulus particularly in relation to cell density and GAG content. Additionally, there were changes in the bony endplate, with fewer openings observed in the caudal than cranial endplates of all discs in both groups. Conclusions Results show the cranial vertebral endplate is the main vascular source for the intervertebral discs. Hylauronic acid molecular weight is the same through the intervertebral disc after age of 50 years.

Intervertebral Disc

10.1371/journal.pone.0203932

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Study of Spine Rotator Muscles in Adolescent Idiopathic Scoliosis Patients

Global Spine Journal (2015)

Marcelo Wajchenberg Délio Eulálio Martins Rafael Paiva Luciano David Del Curto Eduardo Barros Puertas

Introduction Several studies have presented morphological, biochemical, and histopathological changes in the paraspinal skeletal muscle of patients with adolescent idiopathic scoliosis (AIS). Some abnormalities, such as an increased amount of type I fibers in the concavity and the decreased number of type II in the convexity, an increase in the intracellular concentration of glycogen and lipids, structural changes in the sarcolemma and myotendinous junction, changes in the activity muscle enzyme, and an increase in intracellular calcium concentration, have been demonstrated. The aim of this article is to evaluate the rotator muscle fibers at the apical vertebra of curves of patients with AIS by histological and immunohistochemical analysis. Materials and Methods Twenty-one patients with AIS submitted to surgical correction between 2010 and 2013 had the spinal rotator muscles biopsied in the concavity and convexity of the apical vertebra of the thoracic curve during the surgery. Serial cryosections were stained with hematoxylin and eosin (HE), Sudan Red, NADH, ATPase, and Cytochrome oxidase. We evaluated muscle atrophy and hypertrophy, fatty proliferation, presence of endomysial and perimysial fibrosis, presence of hyaline fibers, mitochondrial proliferation, muscle necrosis, nuclear centralization, and inflammation. Two independent observers evaluated the sections. Results The average value of the angle of the main thoracic curve was 68 degrees Cobb. For analysis of nonparametric paired variables between the concave and convex sides, McNemar test was used with a significance level of 5%. The results of relative frequency and “ p” values showed significant differences in both endomysial and perimysial fibrosis and fatty involution when compared with both sides of the apical vertebra. Conclusion The paraspinal muscles at the apex of the deformity had a higher involvement in the concavity when analyzing the fatty involution and fibrosis. However, both sides showed signs of myopathy, muscle atrophy through areas of necrosis, presence of hyaline fibers, and mitochondrial proliferation.

10.1055/s-0035-1554350

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The Effectiveness of the AOSpine Project of Education in Research: Changing Paradigms, Provoking Ideas, and Innovating the Mindful Practice

Global Spine Journal (2015)

Asdrúbal Falavigna Álvaro Silva Délio Eulálio Martins José Antonio Román Jiménez Juan Pablo Guyot

Introduction The way to increase innovation in mindful practice in a region without a culture in scientific investigation is through implementation of the Research Curriculum that is based on the competencies and learning outcome. No institutions have a Research Curriculum based on competence and learning outcome as guide to improve knowledge in research. The objective of this study is to describe the effectiveness of the project of education in research and the way to deliver this information effectively to those who aim to further improve their knowledge and participation in research. Materials and Methods the AO Research Curriculum uses the competency-based approach that aligns the following four components: (1) knowledge in research, (2) performing research, (3) specialized technical professional support, and (4) assessment to identify needs and track progress. The content of the curriculum was delivered using the most appropriate learning methods and techniques from the following four perspectives: (1) e-learning methods, (2) specific research symposiums, (3) precourses before AO activities, or as (4) specific lectures and structural presentations within the course, symposiums, or seminars. Research mentoring projects and joint publications are an objective way to measure the effectiveness of the project, as it represents the capacity to perform research. This protocol was applied in spine surgeons and university students. Results The survey of AOSpine Latin America members showed a low level of knowledge regarding research combined with a high motivation to learn. The organized competences, learning outcomes, and syllabus of the knowledge in Research promoted active learning and engagement of the members during AOSpine activities. These activities resulted in an increased membership, the participants were grateful when they understood the usefulness of research, and it was the best way to expand the AO product at the University, not only in the undergraduate courses, but also at the postgraduate levels as learning about tools in research and needs are the same for several areas (medicine, nursing, engineering, biology, and law). Conclusion The education in research project showed to be effective. The learning outcomes gained by the participants following completion of this project were recognized concerning where and how they can best obtain reliable information, perform a critical literature review, choose validated instruments to measure the patient's disease, obtain reliable feedback regarding the effectiveness of our surgical activity, and achieve a better understanding of the positive influence of the research on the medical routine. The “publication of results” is only a consequence of an attitude toward scientific investigation.

Syllabus

10.1055/s-0035-1554552

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Trends in scientific publications of Indian spine surgeons over 14 years (2000–2013)

Indian Journal of Orthopaedics (2016)

Rishi Mugesh Kanna Asdrúbal Falavigna Pedro Guarise da Silva Francine Würzius de Quadros Luiz Henrique Merlin

10.4103/0019-5413.181797

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Citations (7)

Options for surgical treatment of cervical fractures in patients with spondylotic spine: a case series and review of the literature

Journal of Medical Case Reports (2015)

Pedro Alves Délio Eulálio Martins Renato Hiroshi Salvioni Ueta David Del Curto Marcelo Wajchenberg

The surgical treatment of unstable cervical fractures is challenging for spinal surgeons. Unstable cervical fractures associated with spondyloarthropathy and deformities that alter function, form and stability present a greater challenge. Having multiple options to manage this difficult situation is important to all spine surgeons and the results of each case depends on the singular characteristics of patients. The purpose of this case report is to describe the main forms of presentation of unstable cervical subaxial fractures in the spondylotic spine and their surgical treatments.We present three cases of Caucasian men aged 30, 53 and 59 years with spondylosis with unstable cervical fractures and alternatives choices for surgical treatment, and a review of the literature. Each patient underwent a different surgical procedure of the cervical subaxial spine using an isolated anterior, posterior or combined approach demonstrating good outcomes in all cases.The treatment of subaxial cervical spinal fractures is complex, and when these fractures are associated with the deformities caused by spondyloarthropathies they can be thought provoking for spine surgeons such as orthopedists or neurosurgeons. The isolated anterior, posterior and combined approaches are safe and effective for treating these pathologies.

Cervical spondylosis

Presentation (obstetrics)

10.1186/s13256-015-0720-7

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Citations (3)