ALEXANDRE FOGACA CRISTANTE

(Fonte: Lattes)
Índice h a partir de 2011
15
Lattes
ResearcherID
ORCID
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

Filtros

Limpar filtros

Configurações

Assunto: Spine ×

Resultados de Busca

Agora exibindo 1 - 10 de 22
  • article 0 Citação(ões) na Scopus
    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 de
    OBJECTIVE: 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.
  • article 5 Citação(ões) na Scopus
    En bloc vertebrectomy for the treatment of spinal lesions. Five years of experience in a single institution: a case series
    (2018) ARAUJO, Alex Oliveira de; NARAZAKI, Douglas Kenji; TEIXEIRA, William Gemio Jacobsen; GHILARDI, Cesar Salge; ARAUJO, Pedro Henrique Xavier Nabuco de; ZERATI, Antonio Eduardo; MARCON, Raphael Martus; CRISTANTE, Alexandre Fogaca; BARROS FILHO, Tarcisio Eloy Pessoa de
    OBJECTIVES: The objective of this study is to describe the experience of a Brazilian public university hospital regarding the treatment of metastatic or benign spine lesions with en bloc vertebrectomy of the thoracic and lumbar spines. METHODS: This study was a retrospective case series and included all medical records of patients with benign aggressive, primary malignant, or metastatic spine lesions who underwent en bloc vertebrectomy from 2010 to 2015. RESULTS: A total of 17 patients were included in the analysis. Most of them (71%) were indicated for surgery based on an oncologic resection for localized disease cure. Overall, 10 of the 17 patients (59%) underwent vertebrectomy via an isolated posterior approach using the technique described by Roy-Camille et al. and Tomita et al., while 7 patients (41%) underwent double approach surgeries. Of the 17 patients who underwent the en bloc resection, 8 are still alive and in the outpatient follow-up (47%), and almost all patients with metastatic lesions (8/9) died. The average survival time following the surgical procedure was 23.8 months. Considering the cases of metastatic lesions and the cases of localized disease (malignant or benign aggressive disease) separately, we observed an average survival time of 15 months and 47.6 months respectively. CONCLUSION: This study demonstrates and reinforces the reproducibility of the en bloc vertebrectomy technique described by Tomita et al.
  • article 0 Citação(ões) na Scopus
    TOMOGRAPHIC ANALYSIS OF SUBAXIAL CERVICAL VERTEBRAE IN CHILDREN BETWEEN 0 AND 12 YEARS
    (2017) MACHADO, LUCAS CASTRILLON CARMO; LETAIF, OLAVO BIRAGHI; MARCON, RAPHAEL MARTUS; CRISTANTE, ALEXANDRE FOGAÇA; OLIVEIRA, REGINALDO PERILO; BARROS FILHO, TARCÍSIO ELOY PESSOA DE
    ABSTRACT Objective: Tomographic and anatomic analysis of cervical vertebrae in children from 0 to 12 years of age to verify the possibility of utilization of lateral mass screws. Methods: Twenty-five cervical spine tomographies of children between 0 and 12 years of age, admitted to the emergency room of Hospital das Clínicas of São Paulo were retrospectively analyzed. The following distances were measured: width and length of the lateral masses in the axial section; width and height in the coronal section; height, length and diagonal diameter in the sagittal section. The variables studied were correlated with age and sex and submitted to statistical analysis. Results: The analysis of tomographic measurements of 20 patients showed a correlation between age and dimensions of the lateral mass, which were higher after 6 years of age. In relation to sex, greater measures were observed in males in all axes. With regard to the passage of the screws, we only had 22 masses (11%) that prevented their use. However, when stratified by age, we noticed that no patients had restrictions on the use of the lateral mass screw after the age of 6. Conclusion: This study analyzed the measurements of 200 lateral masses, making it possible to infer that there is an increase of dimensions with age and in males. Through the data, it was possible to affirm that in this sample, considering the implants available in the market, the lateral mass screws could be used in 89% of the lateral masses.
  • 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 0 Citação(ões) na Scopus
    Estabilizações lombares dinâmicas
    (2012) ROCHA, Ivan Dias; CRISTANTE, Alexandre Fogaça; MARCON, Raphael Martus
    The 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.
  • 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 12 Citação(ões) na Scopus
    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 de
    OBJECTIVES: 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.
  • article 37 Citação(ões) na Scopus
    Interobserver agreement for the spine instability neoplastic score varies according to the experience of the evaluator
    (2013) TEIXEIRA, William Gemio Jacobsen; COUTINHO, Pedro Ricardo de Mesquita; MARCHESE, Luiz Delboni; NARAZAKI, Douglas Kenji; CRISTANTE, Alexandre Fogaca; TEIXEIRA, Manoel Jacobsen; BARROS FILHO, Tarcisio Eloy Pessoa de; CAMARGO, Olavo Pires de
    OBJECTIVES: To evaluate the interobserver agreement for the Neoplastic Spine Instability Score (SINS) among spine surgeons with or without experience in vertebral metastasis treatment and physicians in other specialties. METHODS: Case descriptions were produced based on the medical records of 40 patients with vertebral metastases. The descriptions were then published online. Physicians were invited to evaluate the descriptions by answering questions according to the Neoplastic Spine Instability Score ( SINS). The agreement among physicians was calculated using the kappa coefficient. RESULTS: Seventeen physicians agreed to participate: three highly experienced spine surgeons, seven less-experienced spine surgeons, three surgeons of other specialties, and four general practitioners (n = 17). The agreement for the final SINS score among all participants was fair, and it varied according to the SINS component. The agreement was substantial for the spine location only. The agreement was higher among experienced surgeons. The agreement was nearly perfect for spinal location among the spine surgeons who were highly experienced in vertebral metastases. CONCLUSIONS: This study demonstrates that the experience of the evaluator has an impact on SINS scale classification. The interobserver agreement was only fair among physicians who were not spine surgeons and among spine surgeons who were not experienced in the treatment of vertebral metastases, which may limit the use of the SINS scale for the screening of unstable lesions by less-experienced evaluators.
  • article 0 Citação(ões) na Scopus
    THE SINS SCALE IN THE EVALUATION OF STABILITY IN PATIENTS WITH SPINAL METASTASIS
    (2020) LUGÃO, ARIEL FALBEL; SILVEIRA JUNIOR, CLOVIS CASTANHO; TEIXEIRA, WILLIAM GEMIO JACOBSEN; CRISTANTE, ALEXANDRE FOGAÇA
    ABSTRACT Objective To evaluate the distribution of patients seen in the emergency care unit of the Instituto do Câncer do Estado de São Paulo in the categories “stable”, “indeterminate” and “unstable” as classified by the SINS scale. Methods The medical charts of patients treated between May and September 2013 were reviewed. Patients with a diagnosis of spinal metastasis were analyzed and data on age, sex, primary tumor location, neurological status, and the presence and intensity of pain at rest and in movement were obtained. The SINS criteria were used to evaluate the radiological involvement of the spine. Results We included 81 patients with a mean age of 59.57 years; 32 (39.51%) men and 49 (60.49%) women. Breast (19.75%), prostate (18.52%) and lung (17.28%) were the most common primary tumor sites. Only 18 patients (22.22%) had a single lesion and 51 (62.96%) had 3 or more metastatic lesions. Of the total, 56 (69.14%) were of undetermined stability, 19 were stable (23.46%) and 6 were unstable (7.41%). Twenty-two (27.2%) presented neurological deficit in the physical examination. None of the patients with severe deficit, Frankel A or B, were stable according to the SINS classification. All unstable lesions presented with kyphotic and/or scoliotic deviation (p <0.001). Most patients with undetermined lesions (78.6%) and all patients with unstable lesions had mechanical pain (p = 0.001). Conclusion In this case series, there was a high rate of patients classified by the SINS scale as of undetermined instability (69.14%). There was a high number of patients with multiple metastases (62.96%), which was not considered a modifier of the SINS instability criteria and which needs to be the focus of future studies. Level of evidence IV; Case Series.
  • 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.