ROGER SCHMIDT BROCK
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
3 resultados
Resultados de Busca
Agora exibindo 1 - 3 de 3
- Cervical myelopathy caused by ligamentum flavum ossification(2012) PAIVA, Wellingson Silva; SOARES, Matheus Schimidt; BERNARDO, Luca Silveira; BROCK, Roger Schimidt; TEIXEIRA, Manoel Jacobsen
- Avaliação das técnicas cirúrgicas para tratamento da mielorradiculopatia espondilótica cervical(2012) MELUZZI, Alexandre; TARICCO, Mário Augusto; BROCK, Roger Schimidt; DIAS, Mário Rubem Pena; NAKAGUAWA, Gilberto; GUIRADO, Vinícius Monteiro de Paula; TEIXEIRA, Manoel JacobsenOBJECTIVE: To evaluate the efficacy of surgical treatment of cervical spondylotic myeloradiculopathy in the production of postoperative neurological improvement, measured in points by the scale of JOA (Japanese Orthopaedic Association) and the recovery rate and complications of therapy. METHODS: Analysis of medical records and imaging studies of 200 patients undergoing surgical treatment of cervical myeloradiculopathy in HC-FMUSP, from January 1993 to January 2007. Clinical evaluation was quantified by the scale of the JOA, with an average follow-up of 6 years and 8 months. RESULTS: There was post-operative neurological improvement in the anterior and posterior approach, except in laminectomy without fusion, where late neurological deterioration was observed. The anterior approach showed a significantly higher rate of complications related to poor fusion, intervertebral displacement of the graft, adjacent disc syndrome, dysphonia, dysphagia, poor positioning of the graft and plates, nerve root injury and significant higher rate of re-operation. In the posterior approach, increased occurrence of instability and kyphosis in the postoperative, in laminectomy were found, whereas in laminoplasty these conditions were not observed, presenting similar rates to those found for the anterior approach. There was no improvement in axial pain in the laminoplasties and worsening in laminectomies, whereas in discectomias and corpectomias there was significant relief of symptoms. CONCLUSION: The anterior and posterior routes were effective in producing neurological improvement, except for laminectomy without fusion. The anterior approach produced more complications, but is better for pain treatment.
- Fatores prognósticos associados ao tratamento cirúrgico da mielorradiculopatia espondilótica cervical(2012) MELUZZI, Alexandre; TARICCO, Mário Augusto; BROCK, Roger Schimidth; DIAS, Mário Rubem Pena; NAKAGUAWA, Gilberto; GUIRADO, Vinícius Monteiro de Paula; TEIXEIRA, Manoel JacobsenOBJECTIVE: Identify the individual, social, environmental clinical factors and also imaging studies which correlate to the final result of neurological improvement in patients undergoing surgical treatment of cervical spondylotic myelopathy. METHODS: The clinical assessment was quantified by the deficit in JOA scale. We analyzed 200 cases of cervical myeloradiculopathy surgically treated in HC-FMUSP, from January 1993 to January 2007. The mean follow-up was 6 years and 8 months. The analysis was based on radiological criteria of instability by White and Kellgren scale. RESULTS: 80% had improved, 14% stabilized and 6% had worsened. The neurological deterioration was not associated with any clinical, environmental or imaging factor. The neurological improvement was directly proportional to the lower age at surgery, absence of co-morbidity, Hoffman sign, muscular atrophy, spinal cord hyperintensity on MRI, the shortest period of preoperative evolution, better preoperative neurological status and was inversely proportional to the AP diameter of the spinal canal and to multiple cord compressions. An association with smoking was observed. Over 70 years of age, evolution superior to 24 months, muscle atrophy, JOA score equal to or less than seven points and AP canal diameter less than or equal to 6mm were not associated with improvement.