The Use Of Inner Tube In Orthopaedic Surgery: Applications, Advantages And Disadvantages [uso Da Câmara De Ar Em Cirurgia Ortopédica: Aplicações, Vantagens E Desvantagens]

Objective: this paper aimed at promoting the use of the inner tube as a systematic device in orthopedic surgery, such as body holder and protector of bony projections, especially in long-term spine surgeries. Methods: this was a prospective non-randomized study, carried out from 2002 to 2007, with 264 orthopedic procedures. Results: we found that, regardless the time of surgery, there were no areas of pressure around bony prominences or injury of peripheral nerves in the postoperative follow-up. Conclusion: those results could recommend the inner tube as an excellent option like a frame in orthopedic surgery. It is an inexpensive device, easy to obtain, and without known complications.84408411Mouradian, H.M., Simmons, E.H., A frame for spinal surgery to reduce intra-abdominal pressure while continuous traction is applied (1977) J Bone Joint Surg Am, 59 (8), pp. 1098-1099Kumar, S.J., Torres, B.C., Borges, J.L., Quinn, T., A radiolucent spine frame: A modification of the Relton-Hall spine frame (1994) J Pediatr Orthop, 14 (3), pp. 383-384Mirovsky, Y., Neuwirth, M., Michael, M.D., Injuries to the lateral femoral cutaneous nerve during spine surgery (2000) Spine (Phila Pa 1976), 25 (10), pp. 1266-1269Yang, S.H., Wu, C.C., Chen, P.Q., Postoperative meralgia paresthetica after posterior spine surgery: Incidence, risk factors, and clinical outcomes (2005) Spine, 15-30 (18), pp. 547-550Barclay, L., Nghiem, H.T., Meralgia paresthetica may complicate posterior spine surgery CME (2005) Spine, 30, pp. E547-E550Schwartz, D.M., Drummond, D.S., Hahn, M., Ecker, M.L., Dormans, J.P., Prevention of positional brachial plexopathy during surgical correction of scoliosis (2000) J Spinal Disord, 13 (2), pp. 178-182Rigamonti, A., Gemma, M., Rocca, A., Messina, M., Bignami, E., Beretta, L., Prone versus knee-chest position for microdiscectomy: A prospective randomized study of intra-abdominal pressure and intraoperative bleeding (2005) Spine (Phila Pa 1976), 30 (17), pp. 1918-1923Relton, J.E., Hall, J.E., An operation frame for spinal fusion. A new apparatus designed to reduce haemorrhage during operation (1967) J Bone Joint Surg Br, 49 (2), pp. 327-332Gupta, A., Muzumdar, D., Ramani, P.S., Meralgia paraesthetica following lumbar spine surgery: A study in 110 consecutive surgically treated cases (2004) Neurol India, 52 (1), pp. 64-6

Vascular Pattern In Enchondroma And Chondrosarcoma: Clinical And Immunohistologic Study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Introduction: Although cartilaginous tumors have low microvascular density, vessels are important for the provision of nutrition so that the tumor can grow and generate metastasis. The aim of this study was to assess the value of the vascular pattern classification as a prognostic tool in chondrosarcomas (CSs) and its relation with vascular endothelial growth factor (VEGF) expression.Materials and Methods: This was a retrospective study of 21 enchondromas and 57 conventional CSs. Clinical data and outcome were retrieved from medical files. CSs histologic grades (on a scale of 1 to 3) were determined according to the World Health Organization classification. The vascular pattern (on a scale of A to C) was assessed through CD34, according to Kalinski. CD105 and VEGF were also evaluated.Results: Poor outcome was significantly associated with vascular pattern groups B and C. Higher vascular pattern were 6.5 times more frequent in moderate-grade and high-grade CSs than in grade 1 CS. On multivariate analysis, a clear correlation was found between VEGF overexpression and B/C vascular patterns. Only 18 (benign and malignant) tumors stained for CD105.Discussion: The results point to the use of the vascular pattern classification as a prognostic tool in CSs and to differentiate low-grade from moderate-grade/high-grade CSs. Vascular pattern might be also used to complement histologic grade, VEGF immunostaining, and microvascular density, for indicating a patient's prognosis. Low-grade CSs develop under low neoangiogenesis, which conforms to the slow growth rate of these tumors.228600605FAPESP; São Paulo Research FoundationFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Grifone, T.J., Haupt, H.M., Podolski, V., Immunohistochemical expression of estrogen receptors in chondrosarcomas and enchondromas (2008) Int J Surg Pathol, 16, pp. 31-37Reliability of histopathologic and radiologic grading of cartilaginous neoplasms in long bones (2007) J Bone Joint Surg Am, 89, pp. 2113-2123Kalinski, T., Roessner, A., Angiogenesis in cartilage tumors (2010) Pathologe, 31, pp. 177-182Folkman, J., Tumor angiogenesis (1985) Adv Cancer Res, 43, pp. 175-203Dvorak, H.F., Brown, L.F., Detmar, M., Vascular permeability factor/vascular endothelial growth factor, microvascular hipermeability and angiogenesis (1995) Am J Pathol, 146, pp. 1029-1039McGough, R., Aswad, B., Terek, R.M., Pathologic neovascularization in cartilage tumors (2002) Clin Orthop Relat Res, 397, pp. 76-82Terek, R.M., Angiogenesis in chondrosarcoma (2002) Curr Opin Orthop, 13, pp. 449-453Mayrogenesis, A.F., Gambarotti, M., Angelini, A., Chondrosarcoma revisited (2012) Orthopedics, 35, pp. 379-390Amstalden, E.M.I., Tumores do sistema osteoarticular (2004) Patologia Diagnostica de Tumores, pp. 345-352. , Billis A, Vassalo J, eds., 2nd ed. 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