Avaliação do tratamento da discopatia degenerativa cervical pela artrodese via anterior utilizando placas associadas a cages ou cages em peek isoladamente Evaluación del tratamiento de la enfermedad degenerativa del disco cervical por la artrodesis anterior utilizando placas asociadas con jaulas o jaulas en peec, aisladamente Evaluation of cervical degenerative disc disease treatment by anterior arthrodesis using plates associated with cages or cages in peek alone

OBJETIVOS: Avaliar comparativamente o tratamento da discopatia degenerativa cervical por discectomia e artrodese cervical via anterior utilizando placas associadas a cages ou cages em PEEK isoladamente. MÉTODOS: Foi realizado um estudo retrospectivo comparativo entre dois grupos de pacientes operados pela técnica de discectomia e artrodese cervical via anterior. Foram selecionados aleatoriamente 70 pacientes, 35 operados com o método de fixação com placas associadas a cages - denominado Grupo I - e 35 com o cage em PEEK isoladamente - Grupo II. Realizou-se anamnese, exame físico, escores de dor (escala visual e analógica da dor) e função (critérios de Odom's, SF-36, Indice de incapacidade do pescoço) o pré e pós-operatório e exames de imagem. RESULTADOS: Houve predominância de pacientes do sexo feminino em ambos os grupos, com média de idade de 55 anos no Grupo I e 47 no Grupo II. Ambos os grupos apresentaram distribuição semelhante quanto ao número de níveis operados, assim como nas complicações encontradas e escores de dor, cervicalgia e SF36 no pré e pós-operatório. Houve 97.1% de fusão com 94.3% de bons resultados no Grupo I e 100% de fusão, com 97 % de bons resultados no Grupo II. CONCLUSÕES: O estudo comparativo da utilização de placas com cages e cages em PEEK isoladamente apresentou resultados semelhantes e satisfatórios para os grupos estudados, não se constatando superioridade ou inferioridade de um método com relação ao outro.<br>OBJETIVOS: Evaluar comparativamente el tratamiento de la enfermedad degenerativa del disco cervical por discectomía y artrodesis cervical vía anterior, utilizando placas asociadas con el uso de jaulas o estas en PEEK [Poliéster-Éter-Éter-Cetona], aisladamente. MÉTODOS: fue realizado un estudio retrospectivo comparativo de dos grupos de pacientes tratados con la técnica de discectomía y artrodesis cervical vía anterior. Se seleccionaron al azar 70 pacientes, 35 operados por el método de fijación con placas asociadas a jaulas - Grupo I - y 35 con las jaulas en PEEK, aisladamente - Grupo II. Se recolectarondatos de historial clínico, examen físico, puntuaciones de dolor (escala visual y analógica del dolor-EVA) y función (criterios de Odom, SF-36, Índice de Discapacidad Cervical) del pre y posoperatorio y exámenes de imagen. RESULTADOS: Se encontró un predominio de pacientes de sexo femenino en ambos grupos, con una edad promediode 55 años en el Grupo I y de 47 en el Grupo II. Ambos grupos mostraron una distribución similar en el número de niveles operados, así como de las complicaciones encontradas y de las puntuaciones de dolor, índice de discapacidad cervical y SF36 para el pre y posoperatorio. Hubo 97,1% para la fusión y 94,3% de buenos resultados en el Grupo I y el 100% de fusión, con 97% de buenos resultados en el Grupo II. CONCLUSIONES: El estudio comparativo de la utilización de placas con jaulas y estas en PEEK, aisladamente, presentó resultados similares y satisfactorios para los grupos estudiados, sin mostrar superioridad o inferioridad de un método sobre otro.<br>OBJECTIVES: To comparatively evaluate the treatment of cervical degenerative disc disease by anterior approach using plates associated or cages and PEEK device alone. METHODS: A retrospective study comparing two groups of patients treated by anterior arthrodesis was performed. Seventy patients were randomly selected, 35 operated using plates associated with cages - Group I - and 35 with cages in PEEK alone - Group II. Medical history was obtained as well as physical examination, pain scores (pain visual analogue score) and function scores (Odom's criteria, SF-36, Neck Disability Index) and the pre and postoperative imaging studies. RESULTS: There was a predominance of female patients in both groups, with a mean age of 55 years in Group I and 47 in Group II. Both groups showed a similar distribution of the number of levels operated, as well as the complications and pain scores, SF36 and neck disability index pre- and postoperatively. There was a fusion rate of 97.1% with 94.3% of good results in Group I and 100% of fusion, with 97% of good results in Group II. CONCLUSIONS: The comparative study of arthrodesis using anterior approach with use of plates and cages and cages in PEEK alone had similar and satisfactory results for both groups, showing no superiority or inferiority of one method over another

Correction of sagittal plane deformity and predictive factors for a favourable radiological outcome following multilevel posterior lumbar interbody fusion for mild degenerative scoliosis

Purpose Limited data is available in the literature on the radiographic results of multilevel posterior lumbar interbody fusion (MPLIF) in the treatment of degenerative scoliosis. The objective of our study was to evaluate the segmental and global correction achieved with MPLIF in the treatment of degenerative scoliosis. Methods Between 2009 and 2014, 42 patients underwent correction of degenerative scoliosis with MPLIF. Several radiological parameters were measured pre- and post-operatively by two independent observers. A statistical analysis was performed to assess the inter-observer reliability of the measurements and to determine the degree of segmental correction achieved at each intervertebral disc. Using sagittal vertical axis (SVA) less than 47 mm; lumbar lordosis (LL) within 11° of pelvic incidence (PI); and pelvic tilt (PT) no more than 22° as radiological criteria for procedural acceptability, we determined predictive factors for a favourable radiological outcome. Results Forty-two patients (34 female) were included in our study. The average amount of correction per segment was 6.2°. The overall correction achieved with MPLIF was 16.6°. Twenty-six of the 42 patients (61.9 %) had post-operative SVA values less than 47 mm. Nineteen of the 42 patients (45.2 %) had average post-operative LL within 11° of the PI. Sixteen of the 42 patients (38.1 %) had PT less than 22°. Younger age, female gender and a low pre-operative PT were significantly associated with the attainment of a satisfactory sagittal alignment. Conclusion Our results demonstrate that a satisfactory correction can be achieved in degenerative scoliosis with MPLIF. In addition, our results show that it is significantly more likely to achieve a satisfactory radiological outcome in younger, female patients with low pre-operative PT