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Background: Although there are studies that adequately document the linear correlation between pelvic incidence (PI), sacral slope, lumbar lordosis, and thoracic kyphosis, few have analyzed the pelvic-spine correlation including the cervical spine. Methods: This is a cross-sectional study, wherein the cervical spine was evaluated using radiography and computed tomography (CT) scans, the lumbosacral spine and the pelvis was evaluated using radiography, in adult patients without spinal pathology. Using the Surgimap tool, cervical and spinopelvic parameters were calculated by several investigators. To evaluate the correlation between cervical and spinopelvic parameters, Spearman's coefficient was calculated. To evaluate the concordance correlation of the measured parameters of cervical sagittal alignment on tomography and conventional radiography, Lin's coefficient was calculated and Bland-Altman plots were performed. Results: A total of 51 healthy adults were included in a follow-up from January 2019 to December 2020. Cervical sagittal alignment and sagittal spinopelvic alignment were assessed using radiography, and a correlation was observed between T1 slope (T1S) and lumbar mismatch (coefficient of 0.28, P = 0.047). Then, cervical sagittal alignment was evaluated using CT and sagittal spinopelvic alignment using radiography, and no correlation was observed between PI and thoracic inlet angle or cervical mismatch with lumbar mismatch. Conclusion: In asymptomatic patients, in whom cervical sagittal alignment and spinal-pelvic alignment were evaluated, only a positive correlation was found between lumbar mismatch and T1S, which lacks clinical significance. No concordance was identified between lumbar mismatch and cervical mismatch. Therefore, it is inferred that there is an independence between the sagittal spine-pelvic alignment with respect to the sagittal cervical alignment.
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BACKGROUND: Spinal fractures are becoming more frequent and should be handled as a severe and endemic pathology that requires timely diagnosis and adequate treatment. The classification of the AOSpine is currently the classification used for this type of fractures, not only for its approach, but to predict surgical management. METHODS: These patients had spinal fracture reduction procedures done through percutaneous way with expander endovertebral implants, and intraosseous fixation using SpineJack® intravertebral implants plus Cohesion® cement. Within the follow-up scheme, subsequent measurements were taken after a week, a month after surgery, 3 months after the procedure and after 6 months of follow-up. STATA® (Statistical Analysis System, version 12.1, SAS Institute Inc., Cary, NC, USA) was used for all analyzes. The Wilcoxon or Student's t-test was used for comparisons in pairs depending on the normality of the distribution. RESULTS: A clinical follow-up is performed to 20 consecutive patients experiencing spinal compression fractures (SCF) who received percutaneous treatment involving SpineJack® and Cohesion® cement, resulting in a statistically significant decrease of both pain and pain-related disability. No complications arose from the procedure. CONCLUSIONS: According to the observations, which reflect what is found in the world literature, this is an effective and safe way of handling SCF.
RESUMO
RESUMEN Objetivos: El propósito de este estudio fue determinar el desenlace en el egreso y en el seguimiento a un año de los pacientes con trauma craneoencefálico severo sometidos a craniectomía descompresiva primaria y secundaria en la Clínica de la Universidad de La Sabana, en un periodo de cinco años. Pacientes y métodos: Se llevó a cabo una serie de casos retrospectiva de pacientes con trauma craneoencefálico severo sometidos a craniectomía descompresiva entre 2008 y 2013. Los desenlaces primarios fueron la sobrevida y el estado funcional medido por la escala de desenlace de Glasgow al momento del egreso hospitalario y al año de seguimiento. Como desenlaces secundarios se incluyeron el tiempo de latencia para la realización de la craniectomía, las complicaciones intra- y postoperatorias, días de hospitalización y estancia en la unidad de cuidados intensivos, tiempo de ventilación, resultados de la craneoplastia y causa de muerte. Resultados: Treinta y cinco pacientes con trauma craneoencefálico severo fueron sometidos a craniectomía descompresiva en el periodo de estudio, 29 primarias y 6 secundarias, con una latencia mediana de 5 horas y 57 horas, respectivamente. Se observó una sobrevida del 51,4 % de los pacientes, de los cuales 39 % presentó recuperación funcional satisfactoria en la escala de desenlace de Glasgow en el momento del egreso y al año. Conclusiones: En este grupo de pacientes sometidos a craniectomía descompresiva primaria o secundaria, junto con un manejo interdisciplinario y rehabilitación precoz, se presentaron desenlaces funcionales favorables en el seguimiento a largo plazo.
ABSTRACT Aim: The purpose of this study was to determine the outcome, at discharge and at one-year follow-up, of patients with severe traumatic brain injury undergoing primary and secondary decompressive craniectomy at Clinica Universidad de La Sabana, over a period of five years. Patients and methods: We conducted a retrospective case series of patients with severe traumatic brain injury undergoing decompressive craniectomy between 2008 and 2013. Te primary outcomes were survival and functional status, measured by the Glasgow Outcome Scale, both at discharge, and at the one year follow-up. Secondary outcomes included latency time for craniectomy, intra and postoperative complications, days of hospitalization and intensive care unit stay, ventilation time, cranioplasty results, and cause of death. Results: Thirty-five patients with severe traumatic brain injury underwent decompressive craniectomy in the study period, 29 of which were primary and 6, secondary, with a median latency of 5 hours and 57 hours, respectively. A survival of 51.4% of the patients was observed, of which 39% presented satisfactory functional recovery on the Glasgow outcome scale at the time of discharge and one year later. Conclusions: In this group of patients who underwent primary or secondary decompressive craniectomy, together with interdisciplinary management and early rehabilitation, favorable functional outcomes were found in the long-term follow-up.