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1.
Plants (Basel) ; 13(6)2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38592810

RESUMO

The aim of this study is to inventory and study ethnobotanical knowledge of edible plants in the Valencian Community (Spain). In respect to culinary uses, 92 species of plant were reported to be edible, finding the following uses: 58 raw, 52 cooked, 16 fried, 7 dried, 21 in liquors and beverages, 25 in dessert and sweets, 11 as seasoning, 17 in pickles, and 10 to curdle milk. We prepared a database that includes genus, family, scientific, and vernacular names in Spanish and Catalan for each plant. We also created a classification of nine edible uses and plant parts used, being Asteraceae (n = 18), Brassicaceae (n = 7), Chenopodiaceae (n = 6), and Rosaceae (n = 6) the families most characterized for gastronomic purposes. The species with the most elevated cultural importance (CI) values were Foeniculum vulgare (CI = 1.389), Cynara scolymus (CI = 1.374), Papaver rhoeas (CI = 1.211), Beta vulgaris (CI = 1.167), and Juglans regia (CI = 1.155). The most used parts were the leaves (71), flowers (25), and branches (19), while the least used were roots (9) and seeds (8). Traditional knowledge of these plants helps to preserve traditional cuisine, promote the local economy and, in several species, encourage their cultivation.

2.
bioRxiv ; 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38659789

RESUMO

Developmental and Epileptic Encephalopathies (DEEs), a class of devastating neurological disorders characterized by recurrent seizures and exacerbated by disruptions to excitatory/inhibitory balance in the brain, are commonly caused by mutations in ion channels. Disruption of, or variants in, FGF13 were implicated as causal for a set of DEEs, but the underlying mechanisms were clouded because FGF13 is expressed in both excitatory and inhibitory neurons, FGF13 undergoes extensive alternative splicing producing multiple isoforms with distinct functions, and the overall roles of FGF13 in neurons are incompletely cataloged. To overcome these challenges, we generated a set of novel cell type-specific conditional knockout mice. Interneuron-targeted deletion of Fgf13 led to perinatal mortality associated with extensive seizures and impaired the hippocampal inhibitory/excitatory balance while excitatory neuron-targeted deletion of Fgf13 caused no detectable seizures and no survival deficits. While best studied as a voltage-gated sodium channel (Na v ) regulator, we observed no effect of Fgf13 ablation in interneurons on Na v s but rather a marked reduction in K + channel currents. Re-expressing different Fgf13 splice isoforms could partially rescue deficits in interneuron excitability and restore K + channel current amplitude. These results enhance our understanding of the molecular mechanisms that drive the pathogenesis of Fgf13- related seizures and expand our understanding of FGF13 functions in different neuron subsets.

3.
Chem Biol Interact ; 394: 110977, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38548214

RESUMO

The applications of magnetic nanoparticles (MNPs) as biocatalysts in different biomedical areas have been evolved very recently. One of the main challenges in this field is to design affective MNPs surfaces with catalytically active atomic centres, while producing minimal toxicological side effects on the hosting cell or tissues. MNPs of vanadium spinel ferrite (VFe2O4) are a promising material for mimicking the action of natural enzymes in degrading harmful substrates due to the presence of active V5+ centres. However, the toxicity of this material has not been yet studied in detail enough to grant biomedical safety. In this work, we have extensively measured the structural, compositional, and magnetic properties of a series of VxFe3-xO4 spinel ferrite MNPs to assess the surface composition and oxidation state of V atoms, and also performed systematic and extensive in vitro cytotoxicity and genotoxicity testing required to assess their safety in potential clinical applications. We could establish the presence of V5+ at the particle surface even in water-based colloidal samples at pH 7, as well as different amounts of V2+ and V3+ substitution at the A and B sites of the spinel structure. All samples showed large heating efficiency with Specific Loss Power values up to 400 W/g (H0 = 30 kA/m; f = 700 kHz). Samples analysed for safety in human hepatocellular carcinoma (HepG2) cell line with up to 24h of exposure showed that these MNPs did not induce major genomic abnormalities such as micronuclei, nuclear buds, or nucleoplasmic bridges (MNIs, NBUDs, and NPBs), nor did they cause DNA double-strand breaks (DSBs) or aneugenic effects-types of damage considered most harmful to cellular genetic material. The present study is an essential step towards the use of these type of nanomaterials in any biomedical or clinical application.

4.
Arch Orthop Trauma Surg ; 144(4): 1585-1595, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38416137

RESUMO

BACKGROUND: The excessive routine ordering of pretransfusion tests (blood typing, screening, and cross-matching) for surgical cases incurs significant unnecessary costs and places an undue burden on transfusion services. This study aims to systematically review the literature regarding the necessity of routine pretransfusion tests before total hip arthroplasty (THA) or total knee arthroplasty (TKA) and summarize their outcomes. STUDY METHODS: A systematic review and meta-analysis were performed. The study's characteristics, the prevalence of over-ordering pretransfusion tests, transfusion rates, and potential cost savings to the healthcare system were analyzed. RESULTS: The study included 17,667 patients. Pooled results revealed a 96.3% over-ordering pretransfusion test rate (95% CI: 0.92-1.00; p < 0.001) among patients undergoing primary THA or TKA. The pooled prevalence of hospital transfusion rate was 3.6%. Notably, there were statistically significant differences in preoperative hemoglobin (Hb) levels between patients not requiring transfusion (Hb = 13.9 g/dl; 95% CI 12.59-15.20; p < 0.001) and those needing transfusion (Hb = 11.9 g/dl; 95% CI 10.69-13.01; p < 0.001) (p = 0.03). The per-patient total cost savings ranged from 28.63 to 191.27 dollars. DISCUSSION: Our study suggests that routine pre-transfusion testing for all patients undergoing primary THA or TKA may be unnecessary. We propose limiting pretransfusion test orders to patients with preoperative hemoglobin levels below 12 g/dl in unilateral primary TKA or THA. This targeted approach can result in significant cost savings for healthcare systems and transfusion services by reducing the over-ordering of pretransfusion tests in these surgical procedures.


Assuntos
Artroplastia de Quadril , Artroplastia do Joelho , Humanos , Transfusão de Sangue , Tempo de Internação , Hemoglobinas , Estudos Retrospectivos
7.
Nanotechnology ; 34(45)2023 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-37536304

RESUMO

In magnetic tunnel junctions based on iron oxide nanoparticles the disorder and the oxidation state of the surface spin as well as the nanoparticles functionalization play a crucial role in the magnetotransport properties. In this work, we report a systematic study of the effects of vacuum annealing on the structural, magnetic and transport properties of self-assembled ∼10 nm Fe3O4nanoparticles. The high temperature treatment (from 573 to 873 K) decomposes the organic coating into amorphous carbon, reducing the electrical resistivity of the assemblies by 4 orders of magnitude. At the same time, the 3.Fe2+/(Fe3++Fe2+) ratio is reduced from 1.11 to 0.13 when the annealing temperature of the sample increases from 573 to 873 K, indicating an important surface oxidation. Although the 2 nm physical gap remains unchanged with the thermal treatment, a monotonous decrease of tunnel barrier width was obtained from the electron transport measurements when the annealing temperature increases, indicating an increment in the number of defects and hot-spots in the gap between the nanoparticles. This is reflected in the reduction of the spin dependent tunneling, which reduces the interparticle magnetoresistance. This work shows new insights about influence of the nanoparticle interfacial composition, as well their the spatial arrangement, on the tunnel transport of self-assemblies, and evidence the importance of optimizing the nanostructure fabrication for increasing the tunneling current without degrading the spin polarized current.

8.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37544408

RESUMO

INTRODUCTION: The aim of this study was to evaluate the efficacy of aspirin versus low molecular weight heparins (LMWH) for the prophylaxis of venous thromboembolism (VTE), deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing total knee arthroplasty (TKA) and/or total hip arthroplasty (THA). MATERIALS AND METHODS: Systematic review and meta-analysis. Sixteen studies were selected. The risk of VTE, DVT and PE were analyzed. Mortality, risk of bleeding and surgical wound complications was also analyzed. RESULTS: 248,461 patients were included. 176,406 patients with thromboprophylaxis with LMWH and 72,055 patients with aspirin thromboprophylaxis. There were no significant differences in the risk of VTE (OR = 0.93; 95% CI: 0.69-1.26; P = .64), DVT (OR = 0.72; 95% CI: 0.43-1.20; P = .21) or PE (OR = 1.13; 95% CI: 0.86-1.49; P = .38) between both groups. No significant differences were found in mortality (P = .30), bleeding (P = .22), or complications in the surgical wound (P = .85) between both groups. These same findings were found in the sub-analysis of only randomized clinical trials (P>.05). CONCLUSIONS: No increased risk of PE, DVT, or VTE was found among patients with aspirin thromboprophylaxis versus patients with LMWH thromboprophylaxis. There was also no greater mortality, greater bleeding, or greater complications in the surgical wound found among patients with aspirin thromboprophylaxis versus patients with LMWH thromboprophylaxis.

9.
Zootaxa ; 5319(3): 403-412, 2023 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-37518223

RESUMO

We here report two new species of meiofaunal orbiniids belonging to the genus Questa Hartman, 1966, which have been discovered during benthic surveys conducted around the Azores and the Canary Islands. The new species, Q. manuelgerardi n. sp. and Questa ericnunezi n. sp., are described, figured and discussed in detail. Questa manuelgerardi n. sp., endemic from the Azores, is characterized by the lack of furcate chaetae and branchiae, and by the presence of two pairs of anal cirri. Questa ericnunezi endemic from the Canary Island, is defined by the presence of furcate chaetae, 12-18 pairs of branchiae, and two pairs of anal cirri. In addition, new records of the species Q. caudicirra Hartman, 1966 are provided. An identification key to the 12 known species of Questa is also included.

10.
Int J Mol Sci ; 24(13)2023 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-37446126

RESUMO

Clays are considered great nanoadsorbents for many materials, including textile dyes. The use of these materials for cleaning textile wastewater is well known; however, it is not at all common to find applications for the hybrid materials formed from the clay and dye. In this work, a dye-loaded clay material was used to make new dye baths and colour a polyester textile substrate. The same hybrid could be used several times as it did not use all the adsorbed dye in a single dyeing. The hybrid obtained from hydrotalcite (nanoclay) and the dispersed red 1 dye was analysed by measuring the colour obtained, carrying out an X-ray diffraction analysis that provided information after each desorption-dyeing process, and using infrared spectroscopy to analyse the specific bands of each characteristic group. Both analyses showed that the amount of dye present in the hybrid decreases. Thermogravimetry (TGA), surface area and porosity measurements (BET), and X-ray photoelectron spectroscopy (XPS) tests were conducted. Chemical stability was assessed by subjecting the hybrid to the actions of different reagents. In addition, colour fastness tests were carried out after dyeing and washing the polyester test tubes to check for the correct fixing of the dye to the fibre. These fastness results showed that the dyeing was carried out correctly and as if it was a conventional dyeing process.


Assuntos
Corantes , Têxteis , Corantes/química , Argila , Poliésteres
12.
Eur Spine J ; 32(9): 2959-2966, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37481758

RESUMO

PURPOSE: To evaluate the information that patients undergoing spine surgery truly receive and assimilate when they sign their informed consent documents. METHODS: This was a retrospective study on patients who underwent spine arthrodesis or spine discectomy. Patients were given a full explanation of the surgical technique to be employed and its potential risks before they were included on the surgical waiting list. Before surgery, they were asked to sign an informed consent form. The studied variables included whether patients read the informed consent form, whether they recalled the surgical technique used or the spinal segment operated, whether they were aware of the surgical risks involved, and if they had looked for information about their procedure elsewhere. Answers were analyzed by age and educational level. RESULTS: Of a total of 458 total patients, only 51.9% answered all the questions. Sixty-three percent of patients said they had read the informed consent document before surgery. Although 91.6% of patients were aware of the spine segment operated, only 73.5% remembered the surgical technique employed. A total of 63.9% of patients could recall the vertebral levels operated. 39.1% were not aware of the surgical risks involved, and only 16.0% of patients admitted having looked for additional information. A statistically significant correlation was found between the search for additional information and young age (p < 0.001) on the one hand, and high educational level on the other (p = 0.023). CONCLUSION: Even though obtaining informed consent is an important procedure before spinal surgery, almost 40% of the patients in this study underwent surgery without reading the informed consent document or being aware of the risks posed by the procedure.


Assuntos
Consentimento Livre e Esclarecido , Rememoração Mental , Humanos , Estudos Retrospectivos , Procedimentos Neurocirúrgicos
13.
Arch Orthop Trauma Surg ; 143(9): 5641-5648, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37071192

RESUMO

PURPOSE: Malnutrition is a potentially modifiable risk factor of periprosthetic joint infection (PJI). The purpose of this study was to analyze the role of nutritional status as a risk factor for failure after one- stage revision hip or knee arthroplasty for PJI. METHODS: Retrospective, single-center, case-control study. Patients with PJI according to the 2018 International Consensus Meeting criteria were evaluated. Minimum follow-up was 4 years. Total lymphocyte count (TLC), albumin values, hemoglobin, C-reactive protein, white blood cell (WBC) count and glucose levels were analyzed. An analysis was also made of the index of malnutrition. Malnutrition was defined as serum albumin < 3.5 g/dL and TLC < 1500/mm3. Septic failure was defined as the presence of local or systemic symptoms of infection and the need of further surgery as a result of persistent PJI. RESULTS: No significant differences were found between increased failure rates after a one-stage revision hip or knee arthroplasty for PJI and TLC, hemoglobin level, WBC count, glucose levels, or malnutrition. Albumin and C-reactive protein values were found to have a positive and significant relationship with failure (p < 0.05). Multivariate logistic regression identified only hypoalbuminemia (serum albumin < 3.5 g/dL) (OR 5.64, 95% CI 1.26-25.18, p = 0.023) as a significant independent risk factor for failure. The receiver operating characteristic (ROC) curve for the model yielded an area under the curve of 0.67. CONCLUSION: TLC, hemoglobin; WBC count; glucose levels; and malnutrition, understood as the combination of albumin and TLC, were not found to be statically significant risk factors for failure after single-stage revision for PJI. However, albumin < 3.5 g/dL, alone was a statically significant risk factor for failure after single-stage revision for PJI. As hypoalbuminemia seems to influence the failure rate, it is advisable to measure albumin levels in preoperative workups.


Assuntos
Artrite Infecciosa , Artroplastia de Quadril , Hipoalbuminemia , Desnutrição , Infecções Relacionadas à Prótese , Humanos , Estudos Retrospectivos , Estudos de Casos e Controles , Proteína C-Reativa/análise , Infecções Relacionadas à Prótese/etiologia , Infecções Relacionadas à Prótese/cirurgia , Infecções Relacionadas à Prótese/diagnóstico , Hipoalbuminemia/complicações , Hipoalbuminemia/cirurgia , Desnutrição/complicações , Desnutrição/cirurgia , Artrite Infecciosa/cirurgia , Albumina Sérica/análise , Glucose , Artroplastia de Quadril/efeitos adversos , Reoperação/efeitos adversos
14.
Rev. biol. trop ; 71abr. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1449491

RESUMO

Introducción: Enfrentar la acelerada degradación de arrecifes coralinos requiere una acción integrada en múltiples niveles sociales y ecológicos. A escala local se debe incluir la participación activa de los usuarios de los recursos. Objetivo: evaluar el conocimiento y percepción local sobre los arrecifes coralinos en Golfo Dulce, y así generar bases para la integración social en la restauración coralina. Métodos: se realizaron 183 entrevistas en siete comunidades costeras del Golfo Dulce entre septiembre del 2016 y marzo del 2017. Los entrevistados se clasificaron en: (1) Pesca artesanal (PA) = 57 entrevistados, (2) Turismo (T) = 62, y (3) Otros (O) = 64. La primera parte de la entrevista fue de conocimiento y se asignó una nota basada en respuestas correctas. Según la nota se clasificó como informado, información media o desinformado. La segunda parte se basó en escalas de percepción sobre: (I) visitación, (II) factores que dañan los arrecifes coralinos, (III) medidas de manejo y (IV) salud de recursos marinos en Golfo Dulce. Resultados: El grupo T tuvo el mayor porcentaje de entrevistados informados = 42 % y el grupo O de desinformados = 37 %. La segunda parte fue percepción, más del 50 % de PA y T consideran que la visita es frecuente. La sedimentación y contaminación por agroquímicos fueron identificados por más del 60 % de PA y T como la principal amenaza. El 35 % de PA y el 40 % de T perciben las boyas fijas como la mejor medida para el Golfo Dulce. La restricción de visitas fue la medida con menor aceptación. El 60 % de los entrevistados de PA y T consideran que los recursos marinos del golfo estarán peor que en la actualidad. Conclusiones: Estos resultados confirman la importancia de comprender el conocimiento y la percepción de los usuarios de los arrecifes de coral en los procesos participativos y educativos en la restauración y conservación de los arrecifes de coral.


Introduction: Addressing the accelerated coral reefs degradation requires integrated action at multiple social and ecological scales. At local level, active participation of the main users must be included. Objective: To evaluate local knowledge and perception about coral reefs in Golfo Dulce to generate bases for social integration in coral restoration. Methods: 183 interviews were conducted in coastal communities in Golfo Dulce, between September 2016 and March 2017. The interviewees were classified as: (1) Artisanal fishing (PA) = 57 interviewees, (2) Tourism (T) = 62, and (3) Others (O) = 64. The first part of the interview was about knowledge and a grade was assigned based on correct answers. According to the grade, they were classified as informed, medium information or uninformed. The second part was based on perception scales on: (I) visitation, (II) factors that damage coral reefs, (III) management measures, and (IV) health of marine resources in Golfo Dulce. Results: Group T had the highest percentage of informed interviewees = 42 % and group O uninformed = 37 %. The second part was perception, more than 50 % of PA and T consider that the visit is frequent. Sedimentation and contamination by agrochemicals were identified by more than 60 % of PA and T as the main threat. 35 % of PA and 40 % of T perceive permanent buoys as the best measure for the Golfo Dulce. The visitation restriction was the measure with the least acceptance. 60 % of the interviewees of PA and T consider that the marine resources of the gulf will be worse than today. Conclusions: These results confirm the importance of understading coral reefs users knowledge and perception in participatory and educational processes in coral reef restoration and conservation.

16.
Int J Mol Sci ; 24(1)2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36614251

RESUMO

Textile effluents are among the most polluting industrial effluents in the world. Textile finishing processes, especially dyeing, discharge large quantities of waste that is difficult to treat, such as dyes. By recovering this material from the water, in addition to cleaning and the possibility of reusing the water, there is the opportunity to reuse this waste as a raw material for dyeing different textile substrates. One of the lines of reuse is the use of hybrid nanoclays obtained from the adsorption of dyes, which allow dye baths to be made for textile substrates. This study analyses how, through the use of the nanoadsorbent hydrotalcite, dyes classified by their charge as anionic, cationic and non-ionic can be adsorbed and recovered for successful reuse in new dye baths. The obtained hybrids were characterised by X-ray diffraction and infrared spectroscopy. In addition, the colour was analysed by spectrophotometer in the UV-VIS range. The dyes made on cotton, polyester and acrylic fabrics are subjected to different colour degradation tests to assess their viability as final products, using reflection spectroscopy to measure the colour attribute before and after the tests, showing results consistent with those of a conventional dye.


Assuntos
Corantes , Indústria Têxtil , Corantes/química , Espectrofotometria Infravermelho , Água
17.
Eur J Orthop Surg Traumatol ; 33(4): 911-918, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35182239

RESUMO

PURPOSE: To analyze the outcomes of elderly patients with periprosthetic fractures around the knee operated on with a distal femur replacement (DFR). METHODS: We performed a retrospective case series study of eleven elderly patients who underwent DFR due to a periprosthetic fracture. Mean follow-up was 30.1 months (SD 28.1). Demographic, clinical and radiological data were reviewed. A descriptive analysis and a study of survival were conducted. Then, a comparative analysis between the patients who needed reoperation and did not need reoperation, and the patients who died and the patients who were alive during the follow-up was performed. RESULTS: Mean age was 77.1 years (SD 13.9). Reoperation rate was 36%, being infection the most common complication (27%). The risk of reoperation increased with a longer time between fracture and surgery. The 36.4% of patients died during the follow-up. Older age, need of blood transfusion and need of early reoperation were related to a higher risk of mortality. CONCLUSION: DFR could be a valuable option for knee periprosthetic fractures in elderly patients. However, surgeons should be aware of the high reoperation and mortality rate.


Assuntos
Artroplastia do Joelho , Fraturas do Fêmur , Fraturas do Joelho , Fraturas Periprotéticas , Humanos , Idoso , Fraturas Periprotéticas/etiologia , Reoperação/efeitos adversos , Fraturas do Fêmur/cirurgia , Artroplastia do Joelho/efeitos adversos , Estudos Retrospectivos , Fêmur/cirurgia , Fixação Interna de Fraturas/efeitos adversos
18.
Injury ; 54 Suppl 3: S26-S29, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35135686

RESUMO

Clinical practices guidelines (CPGs) play a fundamental role in improving healthcare and patients' outcomes by helping clinicians make the best evidence-based decisions for their patients in a time-efficient manner. By following the available methods and criteria to create trustworthy CPGs, panel members can develop high-quality guidelines. However, despite the improvements over the years, CPGs are still subjected to biases and limitations, with conflicts of interest being the ugliest problem GCPs must face. In this review, we discuss the main characteristics of clinical practice guidelines, their pros and cons, and the future challenges they need to overcome.


Assuntos
Atenção à Saúde , Guias de Prática Clínica como Assunto , Humanos
19.
Eur J Orthop Surg Traumatol ; 33(4): 1275-1281, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35608690

RESUMO

PURPOSE: The aim of this study is to review our experience with the pectoralis-major-pedicled bone window for the revision of shoulder arthroplasty. METHODS: This study used the retrospective case series of six patients who underwent a pectoralis-major-pedicled bone window for revision of shoulder arthroplasty, with a minimum follow-up of 2 years. Demographic, clinical, and radiological data were analyzed. RESULTS: The mean age of the included patients was 72.6 years old (standard deviation (SD) 4.7), and 83.3% were women (5/1). The mean follow-up was 36.6 months (range 25-48 months). Five patients had a shoulder hemiarthroplasty and one patient a reverse shoulder arthroplasty. The indications for revision were pain in five patients and recurrent dislocation in one patient. No intraoperative complications were found. One patient developed a wound infection that required debridement and a two-stage revision. Despite complications, 2 years after surgery, the range of motions and functional scores were improved from preoperative levels. The difference between preoperative and postoperative VAS pain scores was 7.1 points (p < 0.001). The difference between preoperative and postoperative CSS and ASES questionnaires were 32 and 31.6 points, respectively (p < 0.001). At the final follow-up, all radiographs showed bone union of the osteotomy, good fixation of all components, without evidence of prosthetic loosening or migration. CONCLUSIONS: Revision of a shoulder arthroplasty using a pectoralis-major-pedicled bone window can be an effective treatment that can yield pain relief; however, improvements in motion and function were difficult to achieve.


Assuntos
Artroplastia do Ombro , Articulação do Ombro , Prótese de Ombro , Humanos , Feminino , Idoso , Masculino , Articulação do Ombro/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Dor Pós-Operatória , Amplitude de Movimento Articular , Reoperação
20.
Eur J Orthop Surg Traumatol ; 33(5): 1875-1884, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35986813

RESUMO

PURPOSE: Compare the outcomes of randomized clinical trials of cervical disc arthroplasty (CDA) versus anterior cervical discectomy with fusion (ACDF), with a minimum follow-up of 7 years. METHODS: Nine randomized clinical trials were selected. The clinical, radiological, and surgical outcomes were analyzed, including functional and pain scores, range of motion, adjacent segment degeneration, adverse events, and need for reoperation. RESULTS: 2664 patients were included in the study. Pooled results indicated that the CDA group had a significantly higher overall success rate (p < 0.001), a higher improvement in the neck disability index (NDI) (p = 0.002), less VAS arm pain (p = 0.01), and better health questionnaire SF-36 physical component (p = 0.01) than ACDF group. Likewise, the pooled results indicated a significantly higher motion rate (p < 0.001), less adjacent syndrome (p < 0.05), and a lower percentage of reoperation (p < 0.001) in the CDA group. There were no significant differences between the CDA and ACDF groups in the neck pain scale (p = 0.11), the health questionnaire SF-36 mental component (p = 0.10), and in adverse events (p = 0.42). CONCLUSION: In long-term follow-up, CDA showed a better overall success rate, better improvement in NDI, less VAS arm pain, better health questionnaire SF-36 physical component, a higher motion rate, less adjacent syndrome, and less reoperation rate than ACDF. No significant differences were found in the neck pain scale, SF-36 mental component, and in adverse events.


Assuntos
Degeneração do Disco Intervertebral , Fusão Vertebral , Humanos , Degeneração do Disco Intervertebral/cirurgia , Seguimentos , Cervicalgia/etiologia , Cervicalgia/cirurgia , Resultado do Tratamento , Vértebras Cervicais/cirurgia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Discotomia/efeitos adversos , Discotomia/métodos , Artroplastia/efeitos adversos , Artroplastia/métodos
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