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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | - |
dc.contributor.author | MELUZZI, Alexandre | - |
dc.contributor.author | TARICCO, Mário Augusto | - |
dc.contributor.author | BROCK, Roger Schimidt | - |
dc.contributor.author | DIAS, Mário Rubem Pena | - |
dc.contributor.author | NAKAGUAWA, Gilberto | - |
dc.contributor.author | GUIRADO, Vinícius Monteiro de Paula | - |
dc.contributor.author | TEIXEIRA, Manoel Jacobsen | - |
dc.date.accessioned | 2014-07-03T20:48:22Z | - |
dc.date.available | 2014-07-03T20:48:22Z | - |
dc.date.issued | 2012 | - |
dc.identifier.citation | COLUNA/COLUMNA, v.11, n.1, p.42-51, 2012 | - |
dc.identifier.issn | 1808-1851 | - |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/5757 | - |
dc.description.abstract | OBJECTIVE: 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. | - |
dc.description.abstract | OBJETIVO: Evaluar la eficacia del tratamiento quirúrgico de la mielorradiculopatía cervical espondilótica en la producción de la mejoría neurológica posoperatoria, medida en puntos en la escala de la JOA y la tasa de recuperación y las complicaciones de la terapia. MÉTODOS: Análisis de los registros médicos y de los exámenes de imagen de 200 pacientes sometidos a tratamiento quirúrgico de la mielorradiculopatía cervical en el HC-FMUSP, desde enero de 1993 a enero de 2007. La evaluación clínica se cuantificó mediante la escala de la JOA, con un segmento promedio de 06 años y 08 meses. RESULTADOS: Se observó una mejoría neurológica posoperatoria en las vías anterior y posterior, con excepción de las laminectomías sin fusión, donde hubo deterioro neurológico tardío. La vía anterior mostró una tasa significativamente mayor de complicaciones relacionadas con el déficit de fusión intervertebral, desplazamiento del injerto, síndrome de disco adyacente, disfonía, disfagia, o mala posición de injerto y placas, lesión de la raíz del nervio y tasa significativamente mayor de nueva intervención quirúrgica. En la vía posterior, mayor incidencia de inestabilidad en la cifosis posoperatoria, en la laminectomía, y en la laminoplastia no se observó esto, teniendo esta última tasas similares a las encontradas en la vía anterior. No hubo mejoría en el dolor axial en las laminoplastias y se agravó en las laminectomías, mientras que en las discectomías y las corpectomías se produjo una mejoría significativa de los síntomas. CONCLUSIÓN Las vías anterior y posterior fueron eficaces en la producción de mejoría neurológica, con excepción de las laminectomías sin fusión. La vía anterior produjo más complicaciones, pero el dolor es mejor tratado. | - |
dc.description.abstract | OBJETIVO: Avaliar a eficácia do tratamento cirúrgico da mielorradiculopatia espondilótica cervical na produção de melhora neurológica pós-operatória, aferida em pontos pela escala da JOA e taxa de recuperação e as complicações do tratamento. MÉTODOS: Análise dos prontuários e os exames de imagem de 200 indivíduos submetidos a tratamento cirúrgico da mielorradiculopatia cervical no HC-FMUSP, no período de janeiro de 1993 a janeiro de 2007. A avaliação clínica foi quantificada pela escala da JOA, com média de segmento de 06 anos e 08 meses. RESULTADOS: Evidenciou-se melhora neurológica pós-operatória nas vias anterior e posterior, exceto nas laminectomias sem fusão, onde houve piora neurológica tardia. A via anterior mostrou um significante maior índice de complicações, relacionados a déficit de fusão intervertebral, deslocamento de enxerto, síndrome de disco adjacente, disfonia, disfagia, o mau posicionamento de enxerto e placas, lesão de raiz nervosa e significativo maior índice de re-intervenção cirúrgica. Na via posterior maior ocorrência de instabilidade em cifose pós-operatória na laminectomia, não sendo observada na laminoplastia, esta última com índices semelhantes aos encontrados na via anterior. Não houve melhora da dor axial nas laminoplastias e houve piora nas laminectomias, enquanto que nas discectomias e corpectomias houve significativa melhora do sintoma. CONCLUSÃO: As vias anterior e posterior foram eficazes em produzir melhora neurológica, exceto as laminectomias sem fusão. A via anterior produziu mais complicações, mas trata melhor a dor. | - |
dc.language.iso | por | - |
dc.publisher | Sociedade Brasileira de Coluna | - |
dc.relation.ispartof | Coluna/Columna | - |
dc.rights | openAccess | - |
dc.subject | Diseases of the spinal cord | - |
dc.subject | Intervertebral disc | - |
dc.subject | Laminectomy | - |
dc.subject | Enfermedades de la médula espinal | - |
dc.subject | Disco intervertebral | - |
dc.subject | Laminectomía | - |
dc.subject | Doenças da medula espinal | - |
dc.subject | Laminectomia | - |
dc.title | Avaliação das técnicas cirúrgicas para tratamento da mielorradiculopatia espondilótica cervical | - |
dc.title.alternative | Evaluation of surgical techniques for treatment of cervical spondylotic myeloradiculopathy | - |
dc.title.alternative | Evaluación de las técnicas quirúrgicas para el tratamiento de la mielorradiculopatía cervical espondilótica | - |
dc.type | article | - |
dc.rights.holder | Copyright Sociedade Brasileira de Coluna | - |
dc.identifier.doi | 10.1590/S1808-18512012000100009 | - |
dc.subject.wos | Orthopedics | - |
dc.subject.wos | Rehabilitation | - |
dc.type.category | original article | - |
dc.type.version | publishedVersion | - |
hcfmusp.author.external | DIAS, Mário Rubem Pena:Universidade de São Paulo, São Paulo, BRAZIL | - |
hcfmusp.author.external | NAKAGUAWA, Gilberto:Universidade de São Paulo, São Paulo, BRAZIL | - |
hcfmusp.description.beginpage | 42 | - |
hcfmusp.description.endpage | 51 | - |
hcfmusp.description.issue | 1 | - |
hcfmusp.description.volume | 11 | - |
hcfmusp.origem | SciELO | - |
hcfmusp.origem.id | SCIELO:S1808-18512012000100009 | - |
hcfmusp.origem.id | 2-s2.0-84862130855 | - |
hcfmusp.publisher.city | SÃO PAULO | - |
hcfmusp.publisher.country | BRAZIL | - |
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dc.description.index | SciELO | - |
hcfmusp.citation.scopus | 0 | - |
hcfmusp.scopus.lastupdate | 2024-03-29 | - |
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