ALEXANDRE FOGACA CRISTANTE

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Departamento de Ortopediae Traumatologia, Faculdade de Medicina - Docente
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: Acta Ortopedica Brasileira ×

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Agora exibindo 1 - 10 de 27
  • article 2 Citação(ões) na Scopus
    RADIATION EXPOSURE DURING SPINE SURGERY USING C-ARM FLUOROSCOPY
    (2019) CRISTANTE, Alexandre Fogaca; BARBIERI, Fabio; SILVA, Almy Anacleto Rodrigues da; DELLAMANO, Jose Claudio
    Objective: To evaluate the radiation dose received by staff in spine surgeries, including those who are not considered occupationally exposed workers. Methods: All spinal surgeries performed in the same department during a period of 12 months were evaluated with regard to the exposure of surgeons, scrub nurses, and auxiliary personnel working in the operating room to radiation from C-arm fluoroscopy. Radiation was measured by 15 film badge dosimeters placed on the professionals' lapels, gloves, and room standardized sites. The films were analyzed in the dosimetry laboratory by collections per period. Results: During the 12 months, 81 spinal surgeries were performed by the same team, with surgical times ranging from 1 to 6 hours. The total radiation dose ranged from 0.16 mSv to 2.29 mSv depending on the dosimetry site. The most exposed site was the wrist of the main surgeon. Conclusion: The results showed that in the spinal surgeries in our setting, the radiation doses are low and within legal limits. Nevertheless, constant training of professionals is essential for radiation protection of medical staff and patients. Level of evidence I/b, exploratory cohort study.
  • article 2 Citação(ões) na Scopus
    SPINE METASTASIS OF INTRACRANIAL HEMANGIOPERICYTOMA: CASE REPORT OF TWO TREATMENTS
    (2019) ARAUJO, Fernando Flores de; NARAZAKI, Douglas Kenji; TEIXEIRA, William Gemio Jacobsen; MARCON, Raphael Martus; CRISTANTE, Alexandre Fogaca; BARROS FILHO, Tarcisio Eloy Pessoa
    Objective: To report the use of two techniques (radiosurgery and en bloc vertebrectomy) on the same patient for the treatment of two metastases in different sites of the spine arising from intracranial hemangiopericytoma. Intracranial hemangiopericytomas are rare, comprising approximately 2.4% of meningeal tumors and <1% of all tumors of the central nervous system. Metastases to the spine are even rarer: The largest case series reported in the literature has 5 and 7 cases. Methods: A 37-year-old man diagnosed with intracranial hemangiopericytoma was referred for a metastatic lesion in T12 and underwent en bloc resection using the Tomita technique. Results: The disease evolved with a metastasis to T2 treated by radiosurgery with 1600 cGy. The patient died 1,706 days after the en bloc resection of T12 and 1324 days after the radiosurgery of T2, and no recurrence occurred in these locations due to progression of the systemic diseases (liver and central nervous system). Conclusion: This is the first case reported in the literature in which two different techniques were used to treat metastatic lesions in the spine from an intracranial hemangiopericytoma and is unique for its use of two treatments in the same patient.
  • article 8 Citação(ões) na Scopus
    A COMPUTERIZED SYSTEM FOR THE APPLICATION OF BASSO, BEATTIE AND BRESNAHAN SCALE IN WISTAR RATS
    (2015) MOLINA, Alessandra Eira Iague Sleiman; CRISTANTE, Alexandre Fogca; BARROS FILHO, Tarcisio Eloy Pessoa de; MOLINA, Marcos Sleiman; MOLINA, Taina Peral
    Objectives: To develop and test a computer program to assist researchers in assigning scores in the application of the Basso, Beattie and Bresnahan (BBB) scale and to compare these scores when doing so in free, targeted and automated computer-assisted modes. Method: To test the program, the participants used the Impactor methodology recommended by the New York University (USA), in which 12 Wistar rats submitted to spinal cord injury were filmed on the 28th day after the injury. Eight researchers from the Laboratory of Medical Investigation, Faculdade de Medicina da Universidade de Sao Paulo, SP, Brazil took part in the study. The two heads of the laboratory, with 15 years of experience in the application of the scale, were considered the gold standard. Results: The results of the scale application were not significantly different in relation to the gold standard, considering the mean of the evaluators in each method: free, targeted and automated form (with the help of the computer). Conclusions: The application of the BBB scale in the automated mode, using the computer program, did not present any difference in relation to the gold standard for all the evaluators.
  • article 11 Citação(ões) na Scopus
    SPINAL CORD INJURY EXPERIMENTAL MODEL AND MOTION EVALUATION PROTOCOL IN WISTAR RATS
    (2011) SANTOS, Gustavo Bispo dos; CRISTANTE, Alexandre Fogaca; MARCON, Raphael Martus; SOUZA, Fabiano Inacio de; BARROS FILHO, Tarcisio Eloy Pessoa de; DAMASCENO, Marcelo Loquette
    Objectives: To determine a standardized spinal cord contusion model and a method for motor assessment in rats with paraplegia. Methods: This study used 20 Wistar rats divided into 4 groups according to level of severity of spinal cord injury; standardized intermediate lesions were made through system MASCIS IMPACTOR (Multicenter Animal Spinal Cord Injury Study): group 1, 12.5mm (mild injury); group 2,25mm (moderate injury); group 3,50mm (severe injury; in the group 4 the animals suffered no injury (control group). Motor function was assessed after 48 hours, using the scale proposed by Basso, Beattie and Bresnahan. Results: Using the model, we observed that the mild contusions (12.5mm height) were effective, and the animals presented acute urinary tract infection one week after the injury. Moderate contusions (25mm height) were effective, and the animals presented urinary infection until 2 weeks after injury. The severe contusions (50mm height) were effective, and the animals presented urinary infection for 3 to 4 weeks and autophagy. Conclusion: The model of spinal cord injury using the system MASCIS IMPACTOR and the functional assessment proposed by Basso, Beattie and Bresnahan is reproducible and can be used, enabling information exchange among different researchers.
  • article 0 Citação(ões) na Scopus
    TOMOGRAPHIC ANALYSIS OF C7, T1 AND T2 VERTEBRAE ANATOMY IN CHILDREN
    (2021) CABRERA, Gabriela Estefania Delgado; FONSECA, Marcelo Giacomin da; TAVARES JUNIOR, Mauro Costa Morais; MARCON, Raphael Martus; CRISTANTE, Alexandre Fogaca; LETAIF, Olavo Biraghi
    Objective: To evaluate and compare anatomical measurements of C7, T1 and T2 vertebrae in children from 3 to 12 years of age to provide useful epidemiological data for determining the safe anatomical margin for transpedicular and translaminar fixation with screws in this population. Methods: This observational retrospective cross-sectional study evaluated 76 computed tomography scans obtained over 6 months, analyzing the following parameters: the angle of attack, length, thickness and diameter of the pedicle; and the angle of attack, length and thickness of the lamina. Results: The lamina length and thickness, as well as pedicle length varied in size according to age. Although the angle of attack was similar across different ages, age-dependent variation occurred in the T1 vertebra. Conclusion: Screws with a 3.5 mm diameter are safe to use in the C7 and T2 pedicles, while the T1 pedicle allows the introduction of larger screws ranging from 3.5-4.5 mm in diameter. In the lamina, 3.5 mm screws are safe for use only in children older than 7 years. However, each case should be analyzed individually, with the present study not aiming to replace the preoperative use of CT.
  • article 8 Citação(ões) na Scopus
    TREATMENT OF ODONTOID FRACTURES
    (2011) PONTIN, Pedro Augusto; BUMLAI, Renam Urt Mansur; LETAIF, Olavo Biraghi; DAMASCENO, Marcelo Loquette; CRISTANTE, Alexandre Fogaca; MARCON, Raphael Martus; IUTAKA, Alexandre Sadao; OLIVEIRA, Reginaldo Perilo; BARROS FILHO, Tarcisio Eloy Pessoa de
    Objective: This article describes a clinical and radiologic retrospective analysis of odontoid fractures in 20 patients accompanied by the IOT-HCFMUSP, from 2004 to 2010. Methods: These fractures were stratified according to their classification (AO/Anderson and D'Alonzo), epidemiologic profile, type of treatment, time to consolidation of the fracture, and complications. Results: It was observed that there was a higher number of odontoid fractures in males (4: 1), between the third and fourth decades of life (60%), and that the main causes of the trauma were falling from heights (60%) and car accidents (25%). Also, 15% of the cases presented neurological deficits. The most prevalent type of odontoid fracture was Type II (55%) followed by Type III (40%). The most prevalent type of treatment used for Type II and III fractures was surgical (73%) and non-surgical (87.5%), respectively. Consolidation of the fracture took place within 16 weeks in 87.5% of surgically treated cases, and in 54.5% of those treated non-surgically. No cases of pseudoarthrosis were found. Conclusion: The surgical treatment of Type II odontoid fractures showed satisfactory results in relation to time to consolidation of the fracture and low incidence of complications, as did the non-surgical treatment used for the Type III fractures. Level of Evidence: Level IV, case series.
  • article 5 Citação(ões) na Scopus
    TOMOGRAPHIC ANALYSIS OF ANATOMICAL PARAMETERS OF THE AXIS IN CHILDREN
    (2012) TORELLI, Alessandro Gonzalez; KOHLMANN, Rafael Bellucci; BIRAGHI, Olavo Letaif; LUTAKA, Alexandre Sadao; CRISTANTE, Alexandre Fogaca; MARCON, Raphael Martus
    Objective: To carry out an anatomical study of the axis with the use of computed tomography (CT) in children aged from two to ten years, measuring the lamina angle, lamina and pedicle length and thickness, and lateral mass length. Methods: Sixty-four CTs were studied from patients aged 24 to 120 months old, of both sexes and without any cervical anomaly. The measurements obtained were correlated with the data on age and sex of the patients. Statistical analysis was performed using the Students ""t"" tests. Results: We found that within the age range 24-48 months, 5.5% of the lamina and 8.3% of the pedicles had thicknesses of less than 3.5mm, which is the minimum thickness needed for insertion of the screw. Between 49 and 120 months, there were no lamina thicknesses of less than 3.5mm, and 1.2% of the pedicle thicknesses were less than 3.5mm values. Neither of the age groups had any lamina and pedicle lengths of less than 12mm, or lateral mass lengths greater than 12mm. Conclusion: The analysis of the data obtained demonstrates that most of the time, is possible to use a 3.5mm pedicle screw in the laminas and pedicles of the axis in children. Level of Evidence: II, Development of diagnostic criteria in consecutive patients.
  • article 0 Citação(ões) na Scopus
    FOUR-LEVEL EN BLOC VERTEBRECTOMY: A NOVEL TECHNIQUE AND LITERATURE REVIEW
    (2018) NARAZAKI, Douglas Kenji; HIGINO, Lucas P.; TEIXEIRA, William Gemio Jacobsen; ROCHA, Ivan Dias da; CRISTANTE, Alexandre Fogaca; BARROS FILHO, Tarcisio Eloy Pessoa de
    Objective: To demonstrate a novel technique for multilevel en bloc post-vertebrectomy reconstruction. Methods: A novel technique for en bloc multiple post-vertebrectomy reconstruction was used in a patient presenting for curative resection of Ewing's Sarcoma at the oncology center of a public university hospital. Results: The procedure described was feasible for en bloc resection of the four vertebrae. The reconstruction was acceptable and satisfactory in terms of mechanical stability and was without any neurological sequelae in the patient. Conclusion: The use of an allograft with a locked intramedullary nail was an adequate solution for reconstructing the anterior and medial spines after multilevel vertebrectomy. In addition, the association of four intramedullary nails provided stability to the reconstruction. Immediate benefits of the technique compared to other commonly used techniques were shorter hospitalization times and reduced surgical morbidity.
  • article 2 Citação(ões) na Scopus
    SACRECTOMY ASSOCIATED WITH VERTEBRECTOMY: A NEW TECHNIQUE USING DOWEL GRAFTS FROM CADAVERS
    (2018) ARAUJO, Thiego Pedro Freitas; NARAZAKI, Douglas Kenji; TEIXEIRA, William Gemio Jacobsen; BUSNARDO, Fabio; CRISTANTE, Alexandre Fogaca; BARROS FILHO, Tarcisio Eloy Pessoa de
    Objective: The purpose of this study was to demonstrate, in a case series, a new sacrectomy technique using an iliac crest dowel graft from a cadaver. Study design: Report of a case series with description of a new surgical technique. Methods: The technique uses four bars to support the posterior spine and a dowel graft in the iliac wings, with compression of the spine and pelvis above it, to support the anterior spine. Three cases were operated on, and in all of them, a vertebrectomy was used. Results: In the first two cases, the technique was performed as a two-stage surgery. The first stage was performed via the anterior and peritoneal access routes, and the second stage via the posterior access route. In the third case, retroperitoneal access via the anterior route meant that the technique could be performed in one stage, resulting in an overall reduction in surgical time (1250 vs. 1750 vs. 990 minutes, respectively). Conclusion: The new technique enables fixation with biomechanical stability, which is essential to support the stress in the lumbosacral transition and promote earlier rehabilitation.
  • article 3 Citação(ões) na Scopus
    THE SAGITAL BALANCE IN IDIOPATIC AND NEUROMUSCULAR SCOLIOSIS
    (2014) BORGES, Paulo Alvim; OCAMPOS, Guilherme Pereira; MANCUSO FILHO, Jose Antonio; LETAIF, Olavo Biraghi; MARCON, Raphael Martus; CRISTANTE, Alexandre Fogaca
    Objectives: To describe and compare the distribution of spinopelvic parameters (SPP) in a Brazilian population with idiopathic scoliosis (IS) and neuromuscular scoliosis (NMS), and evaluate the association between pelvic incidence (PI) and lumbar lordosis (LL). Method: Medical records investigation was performed. Sagital balance angles were measured in patients with neuromuscular and idiopathic scoliosis. Results: IS sample means ( in degrees): PI 55.55; Sacral Slope (SS) 45.35; Pelvic Tilt (PT) 10.19; Lumbar Lordosis ( LL) 43.48; and Thoracic Kyphosis ( TK) 32.10. In NMS: PI 53.77; SS 42.31; PT 11.46; LL 49.46; and TK 45.69. No statistically significant differences in PEP distribution were found between the two types of scoliosis ( p=0,057). The association between pelvic incidence and lumbar lordosis is low among idiopathic scoliosis (R= 0,074) and neuromuscular scoliosis (R= 0,274). Conclusion: PEP measurements in a Brazilian population of idiopathic scoliosis and neuromuscular scoliosis patients are similar to those in the international literature and do not differ statistically between them. The association between LL and PI could not be assessed in this study. Level of Evidence IV, Case Series.