LUCIANO HENRIQUE LOPES FORONI

(Fonte: Lattes)
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Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina - Médico
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina

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  • article 4 Citação(ões) na Scopus
    Outcomes from primary surgical reconstruction of neonatal brachial plexus palsy in 104 children
    (2019) SIQUEIRA, Mario G.; HEISE, Carlos Otto; ALENCAR, Gustavo C.; MARTINS, Roberto S.; FORONI, Luciano
    PurposeThe outcome from microsurgical reconstruction of neonatal brachial plexus palsy (NBPP) varies, and comparison between different series is difficult, given the differences in preoperative evaluation, surgical strategies, and outcome analysis. To evaluate our results, we reviewed a series of children who underwent surgical treatment in a period of 14years.MethodsWe made a retrospective review of 104 cases in which microsurgical repair of the brachial plexus was performed. Strength was graded using the Active Movement Scale. Whenever possible, upper palsies underwent surgery 4 to 6months after birth and total lesions around 3months. The lesions were repaired, according to the type of injury: neurolysis, nerve grafting, nerve transfer, or a combination of techniques. The children were followed for at least 24months.ResultsThe majority of cases were complete lesions (56/53.8%). Erb's palsy was present in 10 cases (9.6%), and 39 infants (37.5%) presented an extended Erb's palsy. The surgical techniques applied were neurolysis (10.5%), nerve grafts (25.9%), nerve transfers (34.6%), and a combination of grafts and transfers (30.7%). The final outcome was considered poor in 41.3% of the cases, good in 34.3%, and excellent in 24%. A functional result (good plus excellent) was achieved in 58.3% of the cases.ConclusionsThere is no consensus regarding strategies for treatment of NBPP. Our surgical outcomes indicated a good general result comparing with the literature. However, our results were lower than the best results reported. Maybe the explanation is our much higher number of total palsy cases (53.8% vs. 25% in the literature).
  • article 8 Citação(ões) na Scopus
    Functional outcome of spinal accessory nerve transfer to the suprascapular nerve to restore shoulder function: Results in upper and complete traumatic brachial plexus palsy in adults
    (2019) SIQUEIRA, Mario G.; MARTINS, Roberto S.; SOLLA, Davi; FAGLIONI, Wilson; FORONI, Luciano; HEISE, Carlos O.
    Background: Shoulder stability, abduction and external rotation are vital for the performance of usual daily tasks. Aims: To compare the functional outcomes in the shoulder following spinal accessory to suprascapular nerve transfer (SASNT). Patients and Methods: Comparison of the outcome of adult patients with upper traumatic brachial plexus palsy undergoing SASNT with patients with complete palsy submitted to the same procedure. Statistical Analysis: Ranges of motion were compared via the Mann-Whitney U test. The percentages of patients with a favorable outcome were compared by the chi-square test. All tests were two-tailed and P values <0.05 were considered statistically significant. Results: SASNT was performed in 76 patients: 23 cases (30.2%) of upper-plexus injuries and 53 cases (69.7%) of complete brachial plexus palsy. Good shoulder abduction was achieved in 15 patients (65.2%) with upper plexus palsy and a good external rotation in 5 (21.7%). In those patients with a good recovery, the average range of motion (ROM) was 53 degrees for shoulder abduction and 71.2 degrees for external rotation. Thirty-six patients (67.9%) with complete palsy had a good shoulder abduction recovery with 30.7 degrees of average ROM, but only 3 patients (5.6%) recovered a good shoulder external rotation with 68.3 degrees of average ROM. There was no statistical difference for the abduction outcome, but the external rotation outcome was superior in the upper plexus palsy group. Conclusion: SASNT is a consistent procedure to achieve functional recovery of shoulder abduction after a partial or complete plexus injury, but the outcomes of external rotation were quite disappointing in both the groups.