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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Discordancia fenotípica en gemelos monocigóticos

David Del Curto Renato Hiroshi Salvioni Ueta Marcelo Wajchenberg Délio Eulálio Martins Eduardo Barros Puertas

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Espondilólise e espondilolistese em ginastas jovens

Revista Brasileira de Ortopedia (2010)

Rafael Mohriak Pedro Debieux Vargas Silva Miguel Trandafilov Délio Eulálio Martins Marcelo Wajchenberg

OBJETIVO: Determinar a presença de espondilólise e espondilolistese em atletas de ginástica artística feminina e correlacionar com dor lombar, história de trauma e carga de treinamento. MÉTODO: Avaliação voluntária de 18 atletas de ginástica olímpica em nível competitivo de oito a 17 anos, com média de 11,3 anos. As ginastas responderam a um questionário em relação às suas atividades esportivas e foram submetidas a exame clínico e radiográfico da coluna lombar. RESULTADOS: A análise das radiografias foi realizada por ortopedistas especialistas em cirurgia de coluna vertebral, obtendo prevalência de 5,56% para espondilólise e não havendo casos de espondilolistese. CONCLUSÃO: A incidência das alterações radiográficas identificadas é semelhante à relatada na literatura para indivíduos não atletas e a lombalgia apontada pelas atletas não apresentou relação direta com a espondilólise ou espondilolistese.

10.1590/s0102-36162010000100014

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Posttraumatic Arachnoid Cyst in the Thoracic Spine with Medullary Compression: Case Report.

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

Abstract Arachnoid cysts are rare; they can occur at all levels of the dural sac, and can have a congenital, traumatic, iatrogenic or inflammatory origin. In the present article, we report a patient presenting a compressive thoracic myelopathy due to an unusual intradural arachnoid cyst with posttraumatic manifestation and its resolution, in addition to a literature review on the subject. These cysts mainly occur at the thoracic spine, followed by the lumbar, lumbosacral and thoracolumbar spines. Traumatic cysts are caused by an injury to the inner dural layer. These lesions produce neurological deficits through a mass effect on the spinal cord. Concomitant compressive myelopathy is even rarer. In case of myelopathy, cyst resection or drainage is the treatment of choice, and it must be performed immediately. Although rare, arachnoid cysts can be a complication of spine fractures; as such, orthopedists and neurosurgeons, who commonly see these injuries, must be prepared for this unusual situation.

Arachnoid cyst

Spinal cord compression

Thoracic vertebrae

Lumbosacral joint

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What is the best way to determine the cause of adolescent idiopathic scoliosis?

PubMed (2015)

Marcelo Wajchenberg Délio Eulálio Martins Monize Lazar

Adolescent idiopathic scoliosis (AIS) is defined as a lateral deviation of the spine associated with rotation that is found in healthy individuals and has no known cause. These subjects do not exhibit neuromuscular conditions or other disorders until the onset of sexual maturation at approximately 10 years of age (1). Diagnosis is challenging; radiography reveals curves of more than 10 degrees by Cobb method (2) without vertebral abnormalities. Additionally, the angular deviation required for diagnosis is controversial, which further complicates diagnosis. In 1995, Winter questioned the accepted diagnostic value used to characterize the disease and proposed that a curve of 5 degrees should be considered pathological or a variation from a normal spine (3). Furthermore, it is important to observe how rotation impacts the condition, as this feature may be more characteristic of the disease than the curvature itself.

Idiopathic scoliosis

Cobb angle

10.3978/j.issn.2305-5839.2015.02.08

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Quality assessment of systematic reviews of surgical treatment of cervical spine degenerative diseases: an overview

Figshare (2022)

Nelson Astur Délio Eulálio Martins Michel Kanas Rodrigo Góes Medéa de Mendonça Aaron T. Creek

ABSTRACT Objective To gather all systematic reviews of surgical treatment of degenerative cervical diseases and assess their quality, conclusions and outcomes. Methods A literature search for systematic reviews of surgical treatment of degenerative cervical diseases was conducted. Studies should have at least one surgical procedure as an intervention. Included studies were assessed for quality through Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) and Assessment of Multiple Systematic Reviews (AMSTAR) questionnaires. Quality of studies was rated accordingly to their final score as very poor (<30%), poor (30%-50%), fair (50%-70%), good (70%-90%), and excellent (>90%). If an article reported a conclusion addressing its primary objective with supportive statistical evidence for it, they were deemed to have an evidence-based conclusion. Results A total of 65 systematic reviews were included. According to AMSTAR and PRISMA, 1.5% to 6.2% of studies were rated as excellent, while good studies counted for 21.5% to 47.7%. According to AMSTAR, most studies were of fair quality (46.2%), and 6.2% of very poor quality. Mean PRISMA score was 70.2%, meaning studies of good quality. For both tools, performing a meta-analysis significantly increased studies scores and quality. Cervical spondylosis studies reached highest scores among diseases analyzed. Authors stated conclusions for interventions compared in 70.7% of studies, and only two of them were not supported by statistical evidence. Conclusion Systematic reviews of surgical treatment of cervical degenerative diseases present “fair” to “good” quality in their majority, and most of the reported conclusions are supported by statistical evidence. Including a meta-analysis significantly increases the quality of a systematic review.

Quality of evidence

10.6084/m9.figshare.19884353

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Apophyseal ring fracture associated with two levels extruded disc herniation: case report and review of the literature Fratura do anel apofisário associada à hérnia discal extrusa de dois níveis: relato de caso e revisão da literatura

José Alexandre Lopes da Silva Alvarenga Fernando Tadashi Salvioni Ueta David Del Curto Renato Hiroshi

Apophyseal ring fractures are rare injuries that may be associated with lumbar disc herniation in young patients. We report a unique case in the literature of a 15-year-old male patient who played football and was admitted at our service complaining of sciatica radiating into the left leg. An apophysial ring injury of L5 vertebral body was observed. This injury caused two extruded disc herniation in adjacent levels. Surgical procedure was indicated after failure of conservative treatment.

Lumbar disc herniation

Disc herniation

Conservative Treatment

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Variations in the phenotypic presentation of adolescent idiopathic scoliosis

David Del Curto Renato Hiroshi Salvioni Ueta Marcelo Wajchenberg Délio Eulálio Martins Eduardo Barros Puertas

Presentation (obstetrics)

Idiopathic scoliosis

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Variações na apresentação fenotípica da escoliose idiopática do adolescente

Coluna/Columna (2010)

David Del Curto Renato Hiroshi Salvioni Ueta Marcelo Wajchenberg Délio Eulálio Martins Eduardo Barros Puertas

OBJETIVO: discutir quais elementos, de acordo com a literatura, são responsáveis pela discordância fenotípica em gêmeos monozigóticos. MÉTODOS: foram levantados os dados ambulatoriais de um par de gêmeas monozigóticas, que incluíram: idade no momento do diagnóstico, tipo de curva, ângulo de Cobb da deformidade na consulta inicial, início do tratamento e último acompanhamento, ápice da curva e ângulo de Cobb aferido nas imagens radiográficas em perfil. RESULTADOS: criança I: curva principal lombar à esquerda, com ângulo de Cobb entre T11-L4 de 17°, e curva torácica direita entre T5-T11 de 14°. Os ápices encontravam-se no disco L1-L2 e na vértebra T8, respectivamente. Um ano depois, se detectou progressão significativa da deformidade, com a curva lombar evoluindo para 24° (T11-L4) e a curva torácica para 23° (T5-T11). Criança II: curva toracolombar de pequena magnitude à direita, com ângulo de Cobb entre T9 e L3 de 18°. O ápice situava-se na vértebra de T12. Um ano depois, observou-se aumento da curva, com o ângulo de Cobb progredindo para 40°. CONCLUSÃO: não obstante a evidência da origem genética para o desenvolvimento da escoliose, admite-se a influência de outros fatores para sua manifestação e progressão. Na literatura, encontram-se algumas explicações para o desenvolvimento da doença, referentes à deficiência de tecidos estruturais encontrada em síndromes e condições específicas, crescimento assimétrico dos membros e tronco, alterações da configuração sagital da coluna vertebral e fatores ligados à natureza, como alimentação.

10.1590/s1808-18512010000100005

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Paracoccidioidomycosis in the spine: case report and review of the literature

Figshare (2022)

José Alexandre Lopes da Silva Alvarenga Délio Eulálio Martins Michel Kanas Hugo Gustavo Kunzle Elizeche A Dell'aquila

ABSTRACT: CONTEXT: Paracoccidioidomycosis is a systemic form of mycosis that spreads hematogenously, secondarily to reactivation of lung infection or infection at another site or to new exposure to the causative agent. Few cases of bone involvement have been reported in the literature and involvement of the spine is extremely rare. CASE REPORT: We describe a case of a 68-year-old male patient with spondylodiscitis at the levels L4-L5 caused by presence of the fungus Paracoccidioides brasiliensis, which was diagnosed through percutaneous biopsy. The patient was treated with sulfamethoxazole and trimethoprim for 36 months, with complete resolution of the symptoms. CONCLUSION: Spondylodiscitis caused by the fungus Paracoccidioides brasiliensis is uncommon. However, in patients with chronic low-back pain who live or used to live in endemic regions, this infection should be considered as a possible differential diagnosis.

10.6084/m9.figshare.20007056

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Comparación de los métodos de Farfan modificado e de Frobin para la medición de la altura del disco intervertebral

Michel Kanas Marcio Squassoni Leite Renato Hiroshi Salvioni Ueta David Del Curto Délio Eulálio Martins

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