IVAN DIAS DA ROCHA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina
23 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 23
- PROFILE OF SPINAL CORD TRAUMA VICTIMS TREATED AT A REFERENCE UNIT IN SÃO PAULO(2018) ARAUJO, ALEX OLIVEIRA DE; FERRONATO, DANILO DE SOUZA; ROCHA, IVAN DIAS DA; MARCON, RAPHAEL MARTUS; CRISTANTE, ALEXANDRE FOGAÇA; BARROS FILHO, TARCÍSIO ELOY PESSOA DEABSTRACT Introduction: Spinal cord trauma (SCT) is an important cause of morbidity and mortality around the world. It affects different age groups, especially young adults who are victims of high-energy trauma. The most effective way to reduce the incidence of spinal cord trauma and its consequences is through preventive campaigns and control and surveillance measures through public agencies. The objective of this study is to outline the epidemiological profile of patients with spinal cord trauma attended at a tertiary care center in the city of São Paulo. Methods: Retrospective, cross-sectional study performed at a reference center for the care of patients with spinal cord injury in the State of São Paulo. Data were collected from the medical records of patients with spinal cord trauma between 2012 and 2016. Results: Of the 515 patients with spinal trauma, 153 (29.7%) had spinal cord injury of which 131 (85.62%) were male, and 22 (14.37%) were female, in a ratio of approximately 6:1. The mean age was 39.45 years. The main cause of spinal cord trauma observed was the fall from heights, with 72 cases (47.05%), and 52.94% were classified as Frankel A. Conclusions: The results showed that the majority of the patients were young, economically active, with low educational level, exposed to accidents that could be largely avoided. Most of these patients also had severe disabling injuries, which usually bring considerable psychological sequelae and economic consequences to the individual and to society. Level of evidence: IV. Type of study: Case series.
- Feasibility of Intralaminar, Lateral Mass, or Pedicle Axis Vertebra Screws in Children Under 10 Years of Age: A Tomographic Study(2012) CRISTANTE, Alexandre Fogaca; TORELLI, Alessandro Gonzalez; KOHLMANN, Rafael Bellucci; ROCHA, Ivan Dias da; BIRAGHI, Olavo Letaif; IUTAKA, Alexandre Sadao; MARCON, Raphael Martus; OLIVEIRA, Reginaldo Perilo; BARROS FILHO, Tarcisio Eloy Pessoa deBACKGROUND: There are several techniques for screw insertion in upper cervical spine surgery, and the use of the 3.5-mm screw is usually the standard. However, there is no consensus regarding the feasibility of using these screws in the pediatric population. OBJECTIVE: To determine the measurement of the lamina angle, lamina and pedicle length and thickness, and lateral mass length of the topographic axial view of the axis vertebra of 2- to 10-year-old children to guide the use of surgical screws. METHODS: Seventy-five computed tomography scans from 24- to 120-month-old patients were studied. Measurements were taken in an axial view of C2 and correlated with 2 age groups and both sexes. Statistical analysis was performed with the Student t test. RESULTS: In the 24- to 48-month age group, only 5.5% of the lamina and 8.3% of the pedicles had thicknesses < 3.5 mm. In the 49- to 120-month age group, there were no lamina thickness values < 3.5 mm, and 1.2% of pedicle thicknesses were < 3.5 mm. Both age groups had no lamina and pedicle lengths < 12 mm and no lateral mass lengths > 12 mm. CONCLUSION: In the majority of cases, the use of 3.5-mm lamina and pedicle screws in children is feasible. A base value of 45 degrees for the spinolaminar angle can be adopted as a reference for insertion of screws in the C2 lamina. This information can be particularly useful for decision making during preoperative planning for C1-C2 or craniocervical arthrodesis in children.
- Effects of estrogen on functional and neurological recovery after spinal cord injury: An experimental study with rats(2015) LETAIF, Olavo Biraghi; CRISTANTE, Alexandre Fogaca; BARROS FILHO, Tarcisio Eloy Pessoa de; FERREIRA, Ricardo; SANTOS, Gustavo Bispo dos; ROCHA, Ivan Dias da; MARCON, Raphael MartusOBJECTIVES: To evaluate the functional and histological effects of estrogen as a neuroprotective agent after a standard experimentally induced spinal cord lesion. METHODS: In this experimental study, 20 male Wistar rats were divided into two groups: one group with rats undergoing spinal cord injury (SCI) at T10 and receiving estrogen therapy with 17-beta estradiol (4mg/kg) immediately following the injury and after the placement of skin sutures and a control group with rats only subjected to SCI. A moderate standard experimentally induced SCI was produced using a computerized device that dropped a weight on the rat's spine from a height of 12.5 mm. Functional recovery was verified with the Basso, Beattie and Bresnahan scale on the 2nd, 7th, 14th, 21st, 28th, 35th and 42nd days after injury and by quantifying the motor-evoked potential on the 42nd day after injury. Histopathological evaluation of the SCI area was performed after euthanasia on the 42nd day. RESULTS: The experimental group showed a significantly greater functional improvement from the 28th to the 42nd day of observation compared to the control group. The experimental group showed statistically significant improvements in the motor-evoked potential compared with the control group. The results of pathological histomorphometry evaluations showed a better neurological recovery in the experimental group, with respect to the proportion and diameter of the quantified nerve fibers. CONCLUSIONS: Estrogen administration provided benefits in neurological and functional motor recovery in rats with SCI beginning at the 28th day after injury.
- Paraspinous Lidocaine Injection for Chronic Nonspecific Low Back Pain: A Randomized Controlled Clinical Trial(2016) IMAMURA, Marta; IMAMURA, Satiko Tomikawa; TARGINO, Rosa Alves; MORALES-QUEZADA, Leon; TOMIKAWA, Luis C. Onoda; TOMIKAWA, Luis G. Onoda; ALFIERI, Fabio M.; FILIPPO, Thais R.; ROCHA, Ivan D. da; NETO, Raul Bolliger; FREGNI, Felipe; BATTISTELLA, Linamara RizzoIn this large, sham-controlled, randomized trial, we examined the efficacy of the combination of standard treatment and paraspinous lidocaine injection compared with standard therapy alone in subjects with chronic low back pain. There is little research-based evidence for the routine clinical use of paraspinous lidocaine injection for low back pain. A total of 378 subjects with nonspecific chronic low back pain were randomized to 3 groups: paraspinous lidocaine injection, analgesics, and exercises (group 1, LID-INJ); sham paraspinous lidocaine injection, analgesics, and exercises (group 2, SH-INJ); and analgesics and exercises (group 3, STD-TTR). A blinded rater assessed the study outcomes at 3 time points: baseline, after treatment, and after 3 months of follow-up. There were increased frequency of pain responses and better low back functional scores in the LID-INJ group compared with the SH-INJ and STD-TTR groups. These effects remained at the 3-month follow-up but differed between all 3 groups. There were significant changes in pain threshold immediately after treatment, supporting the effects of this intervention in reducing central sensitization. Paraspinous lidocaine injection therapy is not associated with a higher risk of adverse effects compared with conventional treatment and sham injection. Its effects on hyperalgesia might correlate with changes in central sensitization. (C) 2016 Published by Elsevier Inc. on behalf of the American Pain Society
- Fraturas do côndilo occipital: atualização da experiência em nosso serviço e revisão da literatura(2013) NORONHA, Henrique Gomes; LETAIF, Olavo Biraghi; ROCHA, Ivan Dias da; IUTAKA, Alexandre Sadao; CRISTANTE, Alexandre Fogaça; OLIVEIRA, Reginaldo Perilo de; BARROS FILHO, Tarcísio Eloy Pessoa deWe present a series of occipital condyle fractures diagnosed and treated in our hospital during the past 10 years. The present study continues an epidemiologic survey already performed in the period 1993-2000. From 2001 to 2011, six cases of fracture of the occipital condyle were diagnosed and all of them were treated conservatively, except one, in which a halo was initially placed. In the five cases treated conservatively, there were good results, with stable segment in functional radiographs, absence of limitation of motion and no pain. The patient treated with halo had FRANKEL C partial quadriplegia and associated fractures (C5, C6, L1, and L2), showing no neurological improvement, besides observing cervical motion limitation. We also highlight the importance of active research on lesions in the occipital-cervical transition, particularly in cases resulting from high-energy trauma, because in addition to the clinical implications of early detection of fracture, the best use of ancillary tests have been an important factor for the increased incidence of fractures of the occipital condyle. As is historically reported, conservative treatment is still effective and has a low rate of complications, and surgical treatment should be indicated in cases with established instability.
- Avaliação de série de pacientes com artrodese C1-C2(2012) GHILARDI, Cesar Salge; LETAIF, Olavo Biraghi; IUTAKA, Alexandre Sadao; CRISTANTE, Alexandre Fogaça; ROCHA, Ivan Dias; MARCON, Raphael Martus; OLIVEIRA, Reginaldo Perilo; BARROS FILHO, Tarcísio Eloy Pessoa deOBJECTIVE: Retrospective record analysis of patients with C1-C2 instability of traumatic and nontraumatic causes who underwent C1-C2 arthrodesis. METHODS: We performed retrospective analysis of medical records of 20 outpatients from the column of IOT-FMUSP aged between 7 and 83 years (mean 43 years) of both sexes. The radiographic parameters for instability were based on measurement of atlanto-axial interval greater than 3 mm in adults and 5 mm in children, using measures obtained from lateral plain X-rays. RESULTS: We operated 20 patients with high cervical instability, mostly due to trauma. The surgical technique used was that described by Magerl. There were no vascular injuries. Infectious complications were reported in two patients. We achieved a solid fusion rate of 85% and no revision surgeries were required. CONCLUSIONS: All techniques produced satisfactory bone healing and were excellent for the control of atlanto-axial instability.
- Estabilizações lombares dinâmicas(2012) ROCHA, Ivan Dias; CRISTANTE, Alexandre Fogaça; MARCON, Raphael MartusThe normal physiological functioning of the spine depends on the normal movement of each motor unit, which consists of two vertebrae and the intervertebral disc interposed between them. Although fusion of a spine motor unit may be used to treat various diseases of the spine, this modality of treatment results in loss of movement of the levels that were fused and consequently may overload the adjacent levels and may cause its degeneration. Proponents of dynamic stabilization techniques believe that it may lead to correction of problems minimizing the risk of degeneration of adjacent levels. Currently there are different market dynamic stabilization methods. Already there are biomechanical studies that prove the theoretical benefit of almost all of them, but it is still missing clinical trials to prove its usefulness and safety for long periods of follow-up to the patient. It is therefore essential that these materials are considered for prospective clinical trial with long period of follow up so that in the near future they may be used precisely and safely to patients.
- Clinical and Radiological Results After Minimally Invasive Transpsoas Lateral Access Surgery for Degenerative Lumbar Stenosis(2020) COUTINHO, Thiago Pereira; CRISTANTE, Alexandre Fogaca; MARCON, Raphael Martus; ROCHA, Ivan Dias da; ONO, Allan Hiroshi; MEYER, Guilherme Pereira Correa; BARROS FILHO, Tarcisio Eloy de PessoaStudy Design: Prospective cohort study. Objective: The lateral transpsoas access is a retroperitoneal approach for the lumbar spine to perform the lateral lumbar interbody fusion (LLIF), an intersomatic arthrodesis performed with a cage placed on the lateral borders of the epiphyseal ring. The procedure can be used to provide indirect decompression of the nervous structures through the discectomy and restoration of the disc height. The objective of the present study was to evaluate the indirect decompression following LLIF both with radiological and clinical parameters. Methods: Prospective clinical and radiological study in a single center with 20 patients diagnosed with 1- or 2-level degenerative lumbar stenosis. Radiological analysis on magnetic resonance imaging included foramen height, canal area, canal diameter, and disc height. Clinical outcomes included visual analogue scale (VAS) and Oswestry Disability Index (ODI) collected up to 12 months. Complications and reoperations were recorded. Results: In total, 25 levels were treated. No reoperation was required. Disc height was increased by an average of 25% (P < .001). The canal area increased from 109 to 149 mm(2) (P < .001) and from 9.3 to 12.2 mm (P < .001) in anteroposterior diameter. The foramen area demonstrated the effect of indirect decompression on both sides (P < .001). The height of the foramen showed significant average increase of 2.8 mm (P < .001). The results from VAS and ODI questionnaires confirmed the clinical effect of indirect decompression. Conclusion: We observed that indirect decompression by the LLIF method is feasible both radiologically and clinically with a low rate of complications and reoperations.
bookPart Dor cervical(2019) ROCHA, Ivan Dias da; CRISTANTE, Alexandre Fogaça; FERRONATO, Danilo de Souza- Controlled medial branch anesthetic block in the diagnosis of chronic lumbar facet joint pain: the value of a three-month follow-up(2014) ROCHA, Ivan Dias da; CRISTANTE, Alexandre Fogaca; MARCON, Raphael Martus; OLIVEIRA, Reginaldo Perilo; LETAIF, Olavo Biraghi; BARROS FILHO, Tarcisio Eloy Pessoa deOBJECTIVES: To verify the incidence of facetary and low back pain after a controlled medial branch anesthetic block in a three-month follow-up and to verify the correlation between the positive results and the demographic variables. METHODS: Patients with chronic lumbar pain underwent a sham blockade (with a saline injection) and then a controlled medial branch block. Their symptoms were evaluated before and after the sham injection and after the real controlled medial branch block; the symptoms were reevaluated after one day and one week, as well as after one, two and three months using the visual analog scale. We searched for an association between the positive results and the demographic characteristics of the patients. RESULTS: A total of 104 controlled medial branch blocks were performed and 54 patients (52%) demonstrated >50% improvements in pain after the blockade. After three months, lumbar pain returned in only 18 individuals, with visual analogue scale scores >4. Therefore, these patients were diagnosed with chronic facet low back pain. The three-months of follow-up after the controlled medial branch block excluded 36 patients (67%) with false positive results. The results of the controlled medial branch block were not correlated to sex, age, pain duration or work disability but were correlated with patient age (p<0.05). CONCLUSION: Patient diagnosis with a controlled medial branch block proved to be effective but was not associated with any demographic variables. A three-month follow-up is required to avoid a high number of false positives.
- «
- 1 (current)
- 2
- 3
- »