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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(05): 828-835
DOI: 10.1055/s-0042-1750797
Artigo Original
Coluna

Impacto dos parâmetros espinopélvicos pré-operatórios na correção de lordose segmentar após fusão intersomática lombar por via lateral de um nível

Article in several languages: português | English
Daniel Arnoni 
1   Instituto de Patologia da Coluna, São Paulo, SP, Brasil
,
Rodrigo Amaral 
1   Instituto de Patologia da Coluna, São Paulo, SP, Brasil
,
Gabriel H. Pokorny 
1   Instituto de Patologia da Coluna, São Paulo, SP, Brasil
,
Rafael Moriguchi 
1   Instituto de Patologia da Coluna, São Paulo, SP, Brasil
,
Luiz Pimenta 
1   Instituto de Patologia da Coluna, São Paulo, SP, Brasil
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Resumo

Objetivos O presente estudo teve como objetivo avaliar se os parâmetros espinopélvicos pré-operatórios podem influenciar o ganho da lordose segmental após fusão intersomática lombar por via lateral de um nível.

Métodos Os seguintes parâmetros radiológicos foram medidos nos raios X: incidência pélvica, lordose lombar, versão pélvica, lordose L4S1, lordose segmental do nível operado, índice intraoperatório de lordose segmentar, mismatch pélvico (IP-LL), proporção de lordose distal, delta de lordose segmentar, PT > 20, inclinação sacral real e inclinação sacral ideal, e a correlação dessas variáveis com o ganho da lordose segmentar foi investigada. Posteriormente, foi realizada uma análise exploratória de cluster para identificar características comuns entre os pacientes e o ganho de lordose segmentar.

Resultados O presente estudo contou com 144 pacientes, dos quais 76% apresentaram ganho de lordose segmentar. Os parâmetros mais correlacionados com o ganho de lordose segmentar foram lordose segmentar pré-operatória (−0,50) e delta intraoperatório de lordose (0,51). Além disso, os pacientes dos grupos de incidência pélvica (IP) alto tiveram tendência de ganho de lordose segmental maior (p < 0,05) e redução do risco de perda de lordose segmental (chances 6.08).

Conclusão Pacientes com perfis de IP médios baixos apresentaram maiores chances de perda de lordose segmentar. No entanto, os parâmetros espinopélvicos pré-operatórios por si só não parecem desempenhar um papel significativo no destino do ganho da lordose segmentar.

Palavras-chave

vértebras lombares - fusão vertebral - lordose - pelve

Suporte Financeiro

O presente estudo não recebeu nenhum apoio financeiro de fontes públicas, comerciais ou sem fins lucrativos.


Estudo desenvolvido no Instituto de Patologia da Coluna (IPC), São Paulo, SP, Brasil.




Publication History

Received: 16 November 2021

Accepted: 28 March 2022

Article published online:
11 July 2022

© 2022. 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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