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DOI: 10.1055/s-0041-1724074
Uso de guia tridimensional personalizado no preparo do orifício do pedículo piloto em deformidades da coluna vertebral
Artikel in mehreren Sprachen: português | English
Resumo
Objetivo O presente estudo teve como objetivo desenvolver e avaliar a utilização de guias personalizadas em pacientes submetidos a cirurgia para correção de deformidades vertebrais com sistema de fixação pedicular.
Métodos Quatro pacientes com deformidade espinhal (três casos de escoliose idiopática e um caso de cifoescoliose congênita) foram submetidos a tratamento cirúrgico corretivo com sistema de fixação pedicular. Protótipos de guias tridimensionais foram desenvolvidos e avaliados quanto à viabilidade técnica, precisão e exposição à radiação.
Resultados O presente estudo incluiu 85 pedículos vertebrais submetidos à inserção de parafusos pediculares na coluna torácica (65,8%) e na coluna lombar (34,2%). A viabilidade técnica foi positiva em 46 pedículos vertebrais (54,1%), sendo 25 torácicos (54%) e 21 lombares (46%). A viabilidade técnica foi negativa em 39 pedículos (45,9%), sendo 31 torácicos (79,5%) e 8 lombares (20,5%). Quanto à precisão, 36 parafusos foram centralizados (78,2%), sendo 17 na coluna torácica (36,9%) e 19 na coluna lombar (41,3%). O mau posicionamento foi observado em 10 parafusos (21,7%), sendo 8 na coluna torácica (17,4%) e 2 na coluna lombar (4,3%). A radiação média registrada nos procedimentos cirúrgicos foi de 5,17 ± 0,72 mSv, e o tempo total de uso da fluoroscopia em cada cirurgia variou de 180,3 a 207,2 segundos.
Conclusão Os protótipos de guias personalizadas permitiram o preparo seguro do orifício piloto nos pedículos vertebrais em casos de deformidade, com maior precisão e menor exposição intraoperatória à radiação.
Contribuição dos Autores
(I) Concepção e delineamento experimental: Teixeira K.O., Defino H.L.A.; (II) Suporte administrativo: nenhum; (III) Fornecimento de materiais de estudo ou pacientes: todos os autores; (IV) Coleta e preparo de dados: Teixeira K.O., Matos T.D., Fleury R.B.C.; (V) Análise e interpretação dos dados: Teixeira K.O., Bergamaschi J.P.M., Defino H.L.A.; (VI) Redação do manuscrito: todos os autores; (VII) Aprovação final do manuscrito: todos os autores.
Suporte Financeiro
Este trabalho teve suporte do Instituto de Pesquisa e Ensino Home, Brasília, DF, Brasil.
Trabalho desenvolvido no Departamento de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Publikationsverlauf
Eingereicht: 31. Juli 2020
Angenommen: 02. Oktober 2020
Artikel online veröffentlicht:
13. August 2021
© 2021. 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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