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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(01): 058-066
DOI: 10.1055/s-0042-1756322
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Coluna

Alinhamento espinopélvico em pacientes com fratura toracolombar explosão

Article in several languages: português | English
Lucas Miotto José 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Pedro Coury 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
,
Robert Meves 
2   Grupo de Coluna, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brasil
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Objetivo Avaliar o alinhamento espinopélvico em pacientes com fratura toracolombar do tipo explosão (FTE) sem déficit neurológico tratados de forma não operatória e operatória em um hospital terciário de referência em trauma.

Método Estudo transversal retrospectivo de pacientes com FTE apenas da região toracolombar, de nível único, do tipo A3 e A4 AOSpine. Análise de dados clínicos, dor lombar (escala visual analógica [EVA]), Escala de Denis, qualidade de vida (SF-36), parâmetros radiográficos sagitais (cifose torácica [CT], cifose toracolombar [CTL], lordose lombar [LL] e eixo vertical sagital [EVS]) e espinopélvicos (incidência pélvica [IP], versão pélvica [VP], inclinação sacral [IS] e a discrepância entre incidência pélvica e lordose lombar [IP-LL]) de pacientes tratados de forma operatória e não operatória.

Resultados O presente estudo avaliou um total de 50 indivíduos com uma média de 50 anos de idade com acompanhamento médio de 109 meses (mínimo de 19 e máximo de 306 meses). Houve diferença significativa entre os tratamentos para Denis trabalho (p = 0,046) a favor do tratamento não operatório. Não houve diferença significativa entre os tratamentos para EVA dor lombar e Denis dor (p = 0,468 e p = 0,623). Não houve diferença significante entre os tratamentos em nenhum dos domínios avaliados do SF-36 (p > 0,05). Parâmetros radiográficos não se mostraram diferentes entre os grupos analisados; contudo, todos os parâmetros radiográficos mostraram diferença significante entre a população considerada assintomática, com exceção da incidência pélvica (p < 0,005).

Conclusões O alinhamento espinopélvico foi normal em pacientes com FTE sem déficit neurológico tratados de forma não operatória e operatória, após acompanhamento mínimo de 19 meses. Entretanto, estes pacientes apresentaram maior média de versão pélvica e de discrepância entre lordose lombar e incidência pélvica quando comparados com os valores de referência da população brasileira.

Palavras-chave

curvaturas da coluna vertebral - fraturas da coluna vertebral - traumatismos da coluna vertebral


Publication History

Received: 01 March 2022

Accepted: 26 July 2022

Article published online:
24 March 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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