ALEXANDRE FOGACA CRISTANTE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Ortopediae Traumatologia, Faculdade de Medicina - Docente
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
27 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 27
- 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.
- Consensus of Clinical Neurorestorative Progress in Patients With Complete Chronic Spinal Cord Injury(2014) HUANG, Hongyun; SUN, Tiansheng; CHEN, Lin; MOVIGLIA, Gustavo; CHERNYKH, Elena; WILD, Klaus von; DEDA, Haluk; KANG, Kyung-Sun; KUMAR, Anand; JEON, Sang Ryong; ZHANG, Shaocheng; BRUNELLI, Giorgio; BOHBOT, Albert; SOLER, Maria Dolors; LI, Jianjun; CRISTANTE, Alexandre Fogaca; XI, Haitao; ONOSE, Gelu; KERN, Helmut; CARRARO, Ugo; SABERI, Hooshang; SHARMA, Hari Shanker; SHARMA, Alok; HE, Xijing; MURESANU, Dafin; FENG, Shiqing; OTOM, Ali; WANG, Dajue; IWATSU, Koichi; LU, Jike; AL-ZOUBI, AdeebCurrently, there is a lack of effective therapeutic methods to restore neurological function for chronic complete spinal cord injury (SCI) by conventional treatment. Neurorestorative strategies with positive preclinical results have been translated to the clinic, and some patients have gotten benefits and their quality of life has improved. These strategies include cell therapy, neurostimulation or neuromodulation, neuroprosthesis, neurotization or nerve bridging, and neurorehabilitation. The aim of this consensus by 31 experts from 20 countries is to show the objective evidence of clinical neurorestoration for chronic complete SCI by the mentioned neurorestorative strategies. Complete chronic SCI patients are no longer told, ""nothing can be done."" The clinical translation of more effective preclinical neurorestorative strategies should be encouraged as fast as possible in order to benefit patients with incurable CNS diseases. This manuscript is published as part of the International Association of Neurorestoratology (IANR) special issue of Cell Transplantation.
- Characterization of traumatic spinal cord injury model in relation to neuropathic pain in the rat(2019) BATISTA, Chary Marquez; MARIANO, Eric Domingos; ONUCHIC, Fernando; DALE, Camila Squarzoni; SANTOS, Gustavo Bispo dos; CRISTANTE, Alexandre Fogaca; OTOCH, Jose Pinhata; TEIXEIR, Manoel Jacobsen; MORGALLA, Matthias; LEPSKI, GuilhermePurpose/aim: Neuropathic pain following spinal cord injury (SCI) has a tremendous impact on patient's quality of life, and frequently is the most limiting aspect of the disease. In view of the severity of this condition and the absence of effective treatments, the establishment of a reliable animal model that reproduces neuropathic pain after injury is crucial for a better understanding of the pathophysiology and for the development of new therapeutic strategies. Thus, the objective of the present study was to standardize the traumatic SCI model in relation to neuropathic pain.Materials and methods: Wistar rats were submitted to SCI of mild intensity (pendulum height 12.5mm) or moderate intensity (pendulum height 25mm) using the New York University Impactor equipment. Behavioural assessment was performed during 8weeks. Thereafter, spinal cords were processed for immunohistochemistry.Results: The animals of the moderate injury group in comparison with mild injury had a greater motor function deficit, worse mechanical allodynia, and latter bladder recovery; moreover, histological analysis revealed more extensive lesions with lower neuronal population.Conclusions: Our study suggests that moderate SCI causes a progressive and long-lasting painful condition (at least 8weeks), in addition to motor impairment, and thus represents a reliable animal model for the study of chronic neuropathic pain after SCI.
- High dose image-guided, intensity modulated radiation therapy (IG-IMRT) for chordomas of the sacrum, mobile spine and skull base: preliminary outcomes(2022) CHEN, Andre Tsin Chih; HONG, Carlos Bo Chur; NARAZAKI, Douglas Kenji; RUBIN, Virginio; SERANTE, Alexandre Ruggieri; RIBEIRO JUNIOR, Ulysses; LIMA, Luiz Guilherme Cernaglia Aureliano de; COIMBRA, Brian Guilherme Monteiro Marta; CRISTANTE, Alexandre Fogaca; TEIXEIRA, William Gemio JacobsenPurpose To report preliminary outcomes of high dose image-guided intensity modulated radiotherapy (IG-IMRT) in the treatment of chordomas of the sacrum, mobile spine and skull base. Methods Retrospective analysis of chordoma patients treated with surgery and/or radiotherapy (RT) in a single tertiary cancer center. Initial treatment was categorized as (A) Adjuvant or definitive high-dose RT (78 Gy/39fx or 24 Gy/1fx) vs (B) surgery-only or low dose RT. The primary endpoint was the cumulative incidence of local failure. Results A total of 31 patients were treated from 2010 through 2020. Median age was 55 years, tumor location was 64% sacrum, 13% lumbar, 16% cervical and 6% clivus. Median tumor volume was 148 cc (8.3 cm in largest diameter), 42% of patients received curative-intent surgery and 65% received primary RT (adjuvant or definitive). 5-year cumulative incidence of local failure was 48% in group A vs 83% in group B (p = 0.041). Tumor size > 330 cc was associated with local failure (SHR 2.2, 95% CI 1.12 to 7.45; p = 0.028). Eight patients developed distant metastases, with a median metastases-free survival of 56.1 months. 5-year survival for patients that received high dose RT was 72% vs 76% in patients that received no or low dose RT (p = 0.63). Conclusion Our study suggests high-dose photon IG-IMRT improves local control in the initial management of chordomas. Health systems should promote reference centers with clinical expertise and technical capabilities to improve outcomes for this complex disease.
bookPart Lesões da Coluna Cervical Baixa(2015) CRISTANTE, Alexandre Fogaça; JORGE, Henrique Menucci Haidar- The management of concussion in sport is not standardized. A systematic review(2021) PIEDADE, Sergio Rocha; HUTCHINSON, Mark R.; FERREIRA, Daniel Miranda; CRISTANTE, Alxandre Fogaca; MAFFULLI, NicolaIntroduction: Concussion is traumatic brain injury with associated tissue damage commonly produced by an indirect or direct head or facial trauma that can negatively impact an athletes' career and personal life. In this context, the importance on how to deal with a concussion has received attention from worldwide literature and has become a topic of enormous interest in the sports medicine arena. Objective: This systematic review aimed to investigate how sports-related concussion is being managed regarding athletic injuries, athletes' age, clinical signs of concussion, adopted questionnaires, as well as decision making in sports medicine. Methods: A systematic review of the literature was performed searching 10 electronic databases with no limitations for year of publication up to December 2019. The search terms used were: Brain Concussion, Athletes, Sports Medicine, Athletic Injuries, Clinical Decision-Making, and Decision Making. The articles were considered eligible when the studies related to populations of regular sports practitioners, professional or recreational, of any age; sports injury; articles reporting concussion evaluation in at least 30 athletes; and articles published in English, French, Portuguese, Italian. We excluded systematic review articles, reviews, editorials, sport-unrelated concussion, no questionnaire application, approaching retired athletes, consensus statement letters, author's reply to editorials, synopsis, and abstracts. Results: The parameters adopted for decision-making and management were broadly variable and were based on a variety of clinical signs or scoring outcomes from a myriad of questionnaires with little consistency in protocol or management guidelines, which could guide the average clinician. Conclusion: This systematic review provides current evidence that post-concussion management in sports medicine has yet to accomplish a standardized protocol that clinicians could use to optimally care for athletes. The extensive number of manuscripts and studies addressing the topic confirms that sports-related concussion in the pediatric and adolescent population has come to the forefront in the sports medicine field.
bookPart Introdução(2017) GIANINI, Reinaldo José; BARROS FILHO, Tarcísio Eloy Pessoa de; CRISTANTE, Alexandre Fogaça; VIEIRA, Luiz AngelobookPart Traumatismo raquimedular(2017) BARROS, Erika M. Kalil Pessoa de; TARICCO, Mario Augusto; OLIVEIRA, Reginaldo Perilo; MARCHESE, Luiz Roberto Delboni; CRISTANTE, Alexandre Fogaça; MEVES, Robert- Gunshot injuries in the spine(2014) BARROS FILHO, T. E. P. de; CRISTANTE, A. F.; MARCON, R. M.; ONO, A.; BILHAR, R.Study design: Review article. Objectives: To review the literature regarding treatment approaches in cases of gunshot wounds (GSWs) affecting the spine. Setting: Brazil. Methods: Narrative review of medical literature. Results: GSWs are an increasing cause of morbidity and mortality. Most patients with spinal GSW have complete neurological deficit. The injury is more common in young men and is frequently immobilizing. The initial approach should follow advanced trauma life support, and broad-spectrum antibiotic therapy should be initiated immediately, especially in patients with perforation of the gastrointestinal tract. The indications for surgery in spinal GSW are deterioration of the neurologic condition in a patient with incomplete neurological deficit, the presence of liquor fistula, spinal instability, intoxication by the metal from the bullet or risk of bullet migration. Conclusion: Surgical treatment is associated with a higher complication rate than conservative treatment. Therefore, the surgeon must know the treatment limitations and recognize patients who would truly benefit from surgery.
bookPart Dor cervical(2019) ROCHA, Ivan Dias da; CRISTANTE, Alexandre Fogaça; FERRONATO, Danilo de Souza
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