Estudio de la señalización. demarcación y semaforización en las vías urbanas localizadas en la comuna 1 centro del municipio de Cúcuta. Norte de Santander.

El presente proyecto tiene como objetivo analizar el estado en que se encuentra la señalización, demarcación y semaforización de vías urbanas en la comuna 1 (centro del municipio de Cúcuta, Norte de Santander). Los resultados presentan una muestra de diez puntos seleccionados aleatoriamente de accidentalidad mediante la recolección, procesamiento y análisis estadísticos de datos históricos en el sector estudiado. Igualmente, se describe el estado en que se encuentra la señalización, demarcación y semaforización de las vías urbanas para la muestra seleccionada. Se evalúa el estado de la señalización vertical y horizontal de los sitios muestreados de acuerdo a las normas de tránsito, el P.O.T del municipio, y el INVIAS. Por último, se evalúa la seguridad vial y la geometría de las vías vehiculares y peatonales seleccionadas.PregradoIngeniero(a) Civi

Spinopelvic parameters: lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope: what does a spine surgeon need to\ua0know\ua0to plan a lumbar deformity correction?

The pelvic incidence defines the amount of lordosis required in the lumbar spine, and a lumbar lordosis within 11° of the pelvic incidence defines alignment of the lumbo-pelvic region. Pelvic tilt is a compensatory mechanism that allows patients to achieve sagittal balance in the setting of decreased lumbar lordosis with the primary compensatory mechanisms being hip extension and knee flexion. Planning an adult lumbar deformity operation requires a comprehensive history and physical examination and thorough radiographic evaluation with the goal of restoring alignment between the pelvic incidence and lumbar lordosis and restoring a normal pelvic tilt

Changes in sagittal spinal alignment and pelvic parameters in patients undergoing a total hip arthroplasty

BACKGROUND: The relationship of the spine to the pelvis has been widely studied. However, the role of the hip joint in maintaining sagittal balance remains poorly understood. We aimed to examine if radiographic sagittal spine and pelvic parameters change after Total Hip Arthroplasty (THA), and to evaluate the postural effects on these parameters in standing, sitting, and supine positions. MATERIALS AND METHODS: 36-inch anteroposterior and lateral standing, sitting and supine radiographs in patients undergoing a unilateral THA pre and post THA were obtained. Standard pelvic and spinal alignment parameters were measured. RESULTS: There were 31 cases with complete radiographic information. Pre-THA SVA was 35.7mm, improving to 24.9mm post-THA. Lumbar lordosis was 50.6° standing and 33.8° sitting; maintained post-THA at 50.6° standing and 36.4°sitting. Pelvic incidence remained unchanged in all positions pre and post-THA (49.1° to 51.2°). Pre-THA sacral slope was 36.9° standing, 23.3° sitting and 40.9° supine. This was maintained post-THA (36.0° standing, 22.9°sitting and 39.7°supine). Pre-THA pelvic tilt was 14.5° standing, 27.8° sitting and 8.8° supine. This was maintained post-THA (15.3° standing, 28.2°sitting and 12.0°supine). Lumbar lordosis was significantly less, and pelvic tilt was significantly greater in sitting position than in standing and supine positions, representing the pelvis moves posteriorly as a patient goes to a seated position,CONCLUSION: This study establishes baseline values for the normal standing, sitting and supine sagittal spine and pelvic parameters patient’s undergoing THA. THA does not seem to lead to substantial changes in sagittal spine and pelvic radiographic parameters

Treatment of Spine Disease in the Elderly Cutting Edge Techniques and Technologies

As the population continues to age worldwide, spinal disease will become more prevalent in the elderly population. The treatment of spinal disease requires an individual approach encorporating best practices. Optimal management in the elderly may differ from younger patients due to increased comorbidities, decreased bone health, and a higher risk of perioperative morbidity and mortality. While more and more elderly patients will require evaluation and management of their spinal disease, most modern books discuss operative and nonoperative management based upon disease process. Techniques and approaches are described for a specific pathology, and are usually tailored for a young or middle aged patient. Treatment of Spine Disease in the Elderly: Cutting Edge Techniques and Technologies is designed to address this gap in today’s literature by expressly addressing spinal conditions in the elderly and current advanced techniques and technologies for treating their spinal disease. It will be intended as a resource for the beginning to the advanced surgeon and practitioner whom undertakes treatment of patients in this age group.

Comparison of revision surgery for pseudarthrosis with or without adjacent segment disease after anterior cervical discectomy and fusion

Background: Patients with a pseudarthrosis after anterior cervical discectomy and fusion (ACDF) may have concurrent adjacent segment disease (ASD). Although prior studies have shown posterior cervical decompression and fusion (PCDF) is effective in repairing pseudarthrosis, improvement in patient reported outcomes (PROs) has been marginal. The aim of this study is to evaluate the effectiveness of PCDF in achieving symptom relief in patients with pseudarthrosis after ACDF and whether that is altered by the additional treatment of ASD. Methods: Thirty-two patients with pseudarthrosis were compared with 31 patients with pseudarthrosis and concurrent ASD after ACDF who underwent revision PCDF with a minimum 1-year follow-up. Primary outcomes measures included the neck disability index (NDI), and numerical rating scale (NRS) scores for neck and arm pain. Secondary measures included estimated blood loss (EBL), operating room (OR) time, and length of stay. Results: Demographics between cohorts were similar, however there was a significantly higher mean body mass index (BMI) in the group with concurrent ASD (32.23 vs. 27.76, p=.007). Patients with concurrent ASD had more levels fused during PCDF (3.7 vs. 1.9, p<.001), greater EBL (165 cc vs. 106 cc, p=.054), and longer OR time (256 minutes vs. 202 minutes, p<.000). Preoperative PROs for NDI (56.7 vs. 56.5, p=.954), NRS arm pain (5.9 vs. 5.7, p=.758), and NRS neck pain (6.6 vs. 6.8, p=.726) were similar in both cohorts. At 12 months patients with concurrent ASD experienced a slightly greater, but not statistically significant, improvement in PROs (Δ NDI 4.40 vs. -1.44, Δ NRS neck pain 1.17 vs. 0.42, Δ NRS arm pain 1.28 vs. 0.10, p=.107). Conclusions: PCDF is a standard procedure for treatment of pseudarthrosis following ACDF, however improvements in PROs are marginal. Slightly greater improvements were seen in patients whose indication for surgery also included concurrent ASD, rather than a diagnosis of pseudarthrosis alone