Experimental model for transforaminal endoscopic spine

Purpose:To validate the porcine spine as a model for learning and practicing transforaminal percutaneous endoscopic lumbar procedures (TF-PELP).Methods:TF-PELP was performed in three porcine cadaver lumbar spine levels. Anatomical features of the current cadaver were compared to human and porcine spines. Performance and documentation of endoscopic procedures were described.Results:This study shows that this representative animal model reflects anatomical characteristics of the human spine. Transforaminal approaches were successfully completed. Although lower disc heights make disc puncture more difficult, the outside-in technique is feasible and more useful to identify anatomical parameters and to practice different surgical steps and maneuvers.Conclusion:This is an effective and representative model for learning and practicing this procedure. Difficulties of the procedure, as well as the differences compared to the human spine, were described.(AU)

Erosão de corpo de vértebra lombar devido à aneurisma de aorta abdominal

In this case report there is a patient with erosion of the fourth lumbar (L4) vertebra due to an infrarenal abdominal aorta aneurysm, which was treated at the Souza Aguiar Municipal Hospital - Rio de Janeiro. The patient is a 51-year-old male, who has had back pain for about four years and a pulsating abdominal tumor. After the clinical examination, an abdominal computed tomography (CT) scan was carried out which showed a tortuous abdominal aorta with an infrarenal dilation of 8.5 cm in diameter and 3.0 cm of lumen. The CT scan also showed erosion of the fourth lumbar vertebra. The treatment consisted of aneurysmectomy of the abdominal aorta whith interposition of a tubular prosthetic graft (Dacron Uni-Graft® 24 mm). There were no complications in the postoperative follow-up.

No presente trabalho é relatado um caso de paciente portador de erosão de vértebra lombar (L4) consequente a um aneurisma de aorta abdominal infrarenal, tratado no Hospital Municipal Souza Aguiar Rio de Janeiro e é feita uma revisão da literatura. O paciente é do sexo masculino, 51 anos, funcionário público com queixas de dores lombares há FONT FACE="Symbol">± /font> 4 anos e uma tumoração pulsátil abdominal. Após o exame clínico foi realizado uma tomografia computadorizada (TC) abdominal a qual evidenciou uma aorta abdominal tortuosa com dilatação aneurismática de 8,5 cm, calcificações parietais difusas e trombos murais, com luz de FONT FACE="Symbol">± /font> 3,0 cm e erosão do corpo vertebral de L4. O tratamento consistiu de uma Aneurismectomia da Aorta Abdominal infrarenal com interposição de enxerto de Dacron (Uni-graft®) tubular 24 mm. A evolução pós-operatória foi satisfatória.