REGINALDO PERILO OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
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
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- 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.
- Fractures of the cervical spine(2013) MARCON, Raphael Martus; CRISTANTE, Alexandre Fogaca; TEIXEIRA, William Jacobsen; NARASAKI, Douglas Kenji; OLIVEIRA, Reginaldo Perilo; BARROS FILHO, Tarcisio Eloy Pessoa deOBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative.
- Avaliação de seis anos de fraturas cervicais subaxiais(2013) GAIA, Leonardo Franco Pinheiro; MIYAHARA, Helder de Souza; LETAIF, Olavo Biraghi; IUTAKA, Alexandre Sadao; CRISTANTE, Alexandre Fogaça; ROCHA, Ivan Dias; MARCON, Raphael Martus; OLIVEIRA, Reginaldo Perilo; BARROS FILHO, Tarcísio Eloy Pessoa deOBJECTIVE: Retrospectively assess the factors related to cervical trauma, according to the type of fracture based on the AO classification, taking into account etiological and epidemiological aspects of the event. METHODS: Records of patients with cervical fractures were retrospectively reviewed, from 2004 to 2009. The sub-axial fractures (C3-C7) were studied because they fit into only one classification (AO). Frontal and lateral x-rays were used as well as CTs to divide the fractures into A (compression), B (distraction) and C (rotation), in accordance with the presented pattern. The following parameters were assessed: gender, age, AO classification, trauma mechanism, presence of neurological deficit, and conservative or surgical treatment. RESULTS: The study included 264 records from the spine, where 216 patients were male and 48 female. The average age of these patients was 38.55 years. The most common mechanism of injury of the cervical sub-axial fractures was car accident with 84 cases. Regarding the type of fracture by the AO classification, the most frequent was type B. Out of the assessed cases, 136 patients presented complete or partial neurological deficit. The surgical treatment was performed in 166 cases. CONCLUSION: It is clear, based on the data presented, that cervical fractures are a major problem to the public and private health in Brazil. The prevention of the cervical fractures presents the most cost-effective approach to these injuries.
- TOMOGRAPHIC CORRELATION OF THE MAGERL TECHNIQUE FOR C1-C2 ARTHRODESIS IN RHEUMATOID ARTHRITIS(2013) MARCHESE, Luiz Roberto Delboni; BONADIO, Marcelo Batista; LETAIF, Olavo Biraghi; CRISTANTE, Alexandre Fogaca; OLIVEIRA, Reginaldo Perilo; BARROS FILHO, Tarcisio Eloy Pessoa deObjective: To use the tomographic analysis of C1 and C2 vertebrae to assess the possibility of using Magerl's technique in patients with rheumatoid arthritis. Other objectives were to obtain anatomical data for the choice of the surgical technique in general, to establish safety parameters and obtain epidemiological data of the population in question. Methods: We retrospectively reviewed the CT scans of 20 patients with rheumatoid arthritis of the Outpatient Spine Group, IOT-HCFMUSP. Data were analyzed statistically to obtain the mean values and the variance of each measurement: the length of the C2 pedicle to the C1 lateral mass, the thickness of the pedicle and the angle of attack of the screw in the isthmus of C2 to the horizontal. Results: The mean values were, respectively: right 23.08 mm and left 23.16 mm, right 6.46 mm and left 6.50 mm, right 44.50 degrees and left 44.95 degrees. Discussion: The leading screw's manufacturers have implants compatible with the anatomical measurements found in this work. Considering the wide diffusion and mastery of Magerl's technique in our country and around the world, this is a safe surgical option that provides mechanical stability. Conclusion: Magerl's technique, according to tomographic analysis, can be used in patients with rheumatoid arthritis. Levels of Evidence IV, Case Series.
- Effects of antidepressant and treadmill gait training on recovery from spinal cord injury in rats(2013) CRISTANTE, A. F.; FILHO, T. E. P. B.; OLIVEIRA, R. P.; MARCON, R. M.; FERREIRA, R.; SANTOS, G. B.Study design: Experimental, controlled, animal study. Objectives: To evaluate the influences of antidepressant treatment, treadmill gait training and a combination of these therapies in rats with experimental, acute spinal cord injury (SCI). Setting: Brazil. Methods: 48 Wistar rats were given standardized SCI; rats were then randomly assigned to four treatment groups: (1) motor rehabilitation therapy for 1 hour daily (gait training); (2) daily treatment with the antidepressant, fluoxetine (0.3 ml per 100 g intraperitoneally), beginning 24 h after the trauma; (3) combined fluoxetine treatment and gait training, or (4) untreated (controls). Neurological recovery was tested with the Basso, Beattie and Bresnahan (BBB) scale at 2, 7, 14, 21, 28,35 and 42 days after injury. Moreover, on day 42, all rats underwent a motor-evoked potential test (MEP); then, after euthanasia, histopathological evaluation was conducted in the area of SCI. Results: Based on the BBB scale, the combined treatment group showed significantly greater improvement compared with the other three groups, from the 14th to the 42nd day of observation. The MEP revealed that all treated groups showed significant improvement compared with the control group (P<0.02 for latency and P<0.01 for amplitude). Conclusion: Our results indicated that a combination of antidepressant and treadmill gait training was superior to either treatment alone for improving functional deficits in rats with experimental, acute SCI.