Combined aerobic and resistance training improves respiratory and exercise outcomes more than aerobic training in adolescents with idiopathic scoliosis: a randomised trial.

Question: In adolescents with idiopathic scoliosis, does combined aerobic and resistance training improve respiratory function, perceived exertion and functional exercise capacity more than aerobic training only?

Design: Randomised controlled trial with concealed allocation, blinded assessors and intention-to-treat analysis.

Participants: Forty adolescents with idiopathic scoliosis and formal indication for surgical correction (spinal curvature ≥ 45 deg).

Intervention: Both groups undertook three 60-minute training sessions per week for 12 weeks.

Balloon Kyphoplasty in the Treatment of Neoplastic Spine Lesions: A Systematic Review.

Study Design: Systematic review.

Objectives: To assess the efficacy of kyphoplasty in controlling pain and improving quality of life in oncologic patients with metastatic spinal disease and pathologic compression fractures of the spine.

Methods: A literature search through medical database was conducted (using PubMed, EMBASE, Cochrane, and LILACS) for randomized controlled trials comparing balloon kyphoplasty versus the traditional treatment for compression fractures of the spine due to metastatic disease.

RESPIRATORY MUSCLE STRENGTH IN IDIOPATHIC SCOLIOSIS AFTER TRAINING PROGRAM.

Objective: To analyze the impact of a physiotherapy protocol in maximum inspiratory and expiratory pressure in patients with adolescent idiopathic scoliosis (AIS) by manovacuometry. AIS may change the respiratory dynamics and the performance of inspiratory and expiratory muscles, affecting ventilatory capacity.

Methods: Patients with AIS aged 10 to 20 years old were randomly assigned to receive an aerobic exercise-training program or no treatment.

Predictors for Postoperative Shoulder Balance in Lenke 1 Adolescent Idiopathic Scoliosis: A Prospective Cohort Study.

Study Design: Prospective cohort.

Objectives: To determine the predictors of the shoulder balance after main thoracic (MT) fusion in patients with Lenke 1 adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Imbalanced shoulders are a major cause of dissatisfaction in AIS patients.

Improved diagnosis of infection associated with osteosynthesis by use of sonication of fracture fixation implants.

Previous studies have shown that sonication fluid cultures from removed orthopedic devices improved the microbiological diagnosis of orthopedic implant-associated infections; however, few of these investigations have applied sonication to the removed fracture fixation devices to evaluate its utility for the diagnosis of osteosynthesis-associated infection (OAI). We compared sonication fluid to conventional tissue cultures from 180 subjects with different sizes of plates and screws (n = 156), spinal implants (n = 26), and intramedullary nails (n = 3), of whom 125 and 55 subjects had OAI and noninfected osteosynthesis (NIO), respectively. The sensitivity for detecting OAI was 90.

Effect of a preoperative protocol of aerobic physical therapy on the quality of life of patients with adolescent idiopathic scoliosis: a randomized clinical study.

Patients with adolescent idiopathic scoliosis (AIS) have lower potential for physical activity because of lung dysfunction and lower muscle strength, which can be reversed by the cardiorespiratory and musculoskeletal conditioning provided by standardized physical activities. We conducted a study to determine if a preoperative protocol of aerobic exercise would improve quality of life (QoL) both before and after training and if there would be any differences between patients who received the therapy and those who did not. Patients with the indication of surgical correction of AIS were randomized to receive or not receive a 4-month preoperative course of aerobic physical training.

Medial patellofemoral ligament anatomy: is it a predisposing factor for lateral patellar dislocation?

Purpose: Because the medial patellofemoral ligament (MPFL) is the primary restraint to lateral dislocation of the patella, we aimed, in this controlled study, to verify whether the MPFL with different measurements could be considered another predisposing factor for patellar dislocation.

Methods: A group of 100 consecutive individuals without the criteria for patellar dislocation (trochlear dysplasia, patella alta and lateral patellar tilt) was recruited as a control group and underwent magnetic resonance imaging (MRI) study and another group of 50 patients with patellar instability. Femoral condyles, interepicondylar distance, length and thickness of the MPFL were measured.

Randomized Clinical Study on Surgical Techniques With Different Pedicle Screw Densities in the Treatment of Adolescent Idiopathic Scoliosis Types Lenke 1A and 1B.

Study Design: Randomized clinical trial.

Objectives: To analyze the impact of surgical techniques with different pedicle screw densities on clinical, functional, and radiographic outcomes, and on costs for patients with adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: The use of pedicle screws to correct spinal deformities has grown.

Prospective evaluation of quality of life in adolescent idiopathic scoliosis before and after surgery.

Study Design: Prospective observational study.

Objective: To assess patient quality of life before and after surgical treatment of adolescent idiopathic scoliosis (AIS) and determine whether an association exists between quality of life and curve magnitude, curve correction, and type of instrumentation.

Summary Of Background Data: Assessment of AIS surgery outcomes has always been based on analysis of radiographic measurements and postoperative curve correction.

THORACOLUMBAR BURST FRACTURE: CORRELATION BETWEEN KYPHOSIS AND FUNCTION AFTER SURGICAL TREATMENT.

Objective: To assess the correlation between post-traumatic kyphosis in patients with thoracolumbar burst fractures undergoing surgical treatment and the functional result from treatment.

Methods: A retrospective study was conducted on 27 patients with thoracolumbar burst fractures according to Denis and A3 to Margerl's classification who met the inclusion criteria for this sample and underwent surgical treatment with a minimum follow-up of six months. The patients' mean age was 46.

Can the interpedicular distance reliably assess the severity of thoracolumbar burst fractures?

Study Design: Retrospective analysis of 260 patients with acute spine fractures treated at a tertiary trauma center from 1989 to 2009.

Objective: To correlate the Interpedicular distance (IPD) to the percentage of narrowing of the spinal canal and to the presence of neurological deficit and laminar fracture in thoracolumbar burst fractures.

Summary Of Background Data: Several reports use radiographic findings such as severity of vertebrae collapse, comminution of the vertebral body, and grade of localized kyphosis to determine the severity of spinal traumas and establish appropriate management.

Thoracolumbar burst fracture: radiographic evaluation on differences between Magerl's A and B.

Objective: Evaluate incidence of Magerl's A and B group in thoracolumbar burst fracture (Denis) according to independent examiners.

Method: According to the posterior spinous process split on the anterior posterior radiography, three independent examiners have analyzed the patients admitted from 2000 to 2009 with thoracolumbar burst fractures (according to Denis) to differentiate between Magerl's type A3 and B1.2.

Cross-cultural adaptation and validity of an adapted Brazilian Portuguese version of Scoliosis Research Society-30 questionnaire.

Study Design: Prospective clinical study developed at a tertiary teaching facility to test an adapted Brazilian Portuguese version of the Scoliosis Research Society-30 (SRS-30) questionnaire.

Objective: To perform cross-cultural adaptation and evaluate the validity of the adapted Brazilian Portuguese version of SRS-30 questionnaire.

Summary Of Background Data: Quality-of-life measurement is a common practice to assess spine diseases.

Correlation between persistent neurological impairment and clinical outcome after microdiscectomy for treatment of lumbar disc herniation.

Background: Outcome of lumbar disc herniation is often based on clinical scores and less frequently on the neurological examination. However, even when clinical outcome measures are favorable, patients may still experience motor or sensory impairment.

Objective: To evaluate the percentage of patients with persistent neurological deficits after lumbar disc surgery and whether these correlate with clinical outcome.

Electronic protocol of respiratory physical therapy in patients with idiopathic adolescent scoliosis.

Objective: To create a clinical database of respiratory function in patients with adolescent idiopathic scoliosis; computerize and store this clinical data through the use of a software; incorporate this electronic protocol to the SINPE© (Integrated Electronic Protocols System) and analyze a pilot project with interpretation of results.

Methods: From the literature review a computerized data bank of clinical data of postural deviations was set up (master protocol). Upon completion of the master protocol a specific protocol of respiratory function in patients with adolescent idiopathic scoliosis was designed and a pilot project was conducted to collect and analyze data from ten patients.

Techniques of lumbar-sacral spine fusion in spondylosis: systematic literature review and meta-analysis of randomized clinical trials.

Background Context: Spine fusions can be performed through different techniques and are used to treat a number of vertebral pathologies. However, there seems to be no consensus regarding which technique of fusion is best suited to treat each distinct spinal disease or group of diseases.

Purpose: To study the effectiveness and complications of the different techniques used for spinal fusion in patients with lumbar spondylosis.

THORACOLUMBAR BURST FRACTURE: LOAD SHARING CLASSIFICATION AND POSTERIOR INSTRUMENTATION FAILURE.

Objectives: To assess the relationship between sagittal collapse, posterior instrumentation failure and the McCormack classification among patients with thoracolumbar burst fractures who had undergone posterior arthrodesis more than one level above and one level below the fracture.

Methods: This was a retrospective review based on the medical records and radiographs of 26 patients who underwent operations between January 1990 and December 2006. The parameters assessed were: worsening of kyphosis (Cobb), neurological dysfunction (Frankel) and failure of surgical treatment (implant breakage or loosening).

[The importance of Injury Severity Score (ISS) in the management of thoracolumbar burst fracture].

Objectives: There are few publications which relate the injury severity score (ISS) to the thoracolumbar burst fractures. For that reason and for the frequency in which they occur, we have evaluated the severity of the trauma in these patients.

Methods: We have evaluated 190 burst fractures in the spinal cord according to Denis, using the codes of Abbreviated Injury Scales (AIS) for the calculation of the ISS, which uses the three parts of the human body with major severity.

Laminar fractures as a severity marker in burst fractures of the thoracolumbar spine.

Purpose: To assess the correlation between the presence of lamina fractures, narrowing of the spinal canal, and the severity of injury.

Methods: Records of 146 men and 44 women aged 13 to 84 (mean, 39) years diagnosed with burst fractures of the thoracolumbar spine were retrospectively reviewed. The laminar fractures and narrowing of the spinal canal were measured using computed tomography.

Objective assessment of the cardiorespiratory function of adolescents with idiopathic scoliosis through the six-minute walk test.

Study Design: Clinical prospective, random study.

Objective: Analyze the results of the six-minute walk test (6MWT) in patients with adolescent idiopathic scoliosis.

Summary Of Background Data: Although it is widely believed that Adolescent Idiopathic Scoliosis (AIS) causes cardiorespiratory dysfunctions, there is no report in literature of objective measurements of this restriction in the ventilatory performance during physical exertion.

Intraoperative neurophysiologic spinal cord monitoring in thoracolumbar burst fractures.

Study Design: Clinical prospective cohort study in academic tertiary setting.

Objective: Evaluate intraoperative neurophysiologic monitoring of the spinal cord in patients with thoracolumbar burst fractures.

Summary Of Background Data: The majority of clinical studies using intraoperative neurophysiologic monitoring in spinal trauma focus exclusively on somatosensory-evoked potentials (SSEP), and there are no specific article on the use of transcranial motor-evoked potentials (TcMEP), and stimulated electromyography (SEMG) by direct stimulation of the pedicular screws in thoracolumbar burst type fractures.

THORACOLUMBAR BURST FRACTURES: CORRELATION BETWEEN KYPHOSIS AND FUNCTION POST NON-OPERATIVE TREATMENT.

Objective: To assess the correlation between kyphosis and post-traumatic symptoms in patients undergoing conservative treatment for thoracolumbar burst fractures.

Methods: A retrospective study was carried out with 36 patients meeting the inclusion criteria for this kind of fracture classified as Denis and Magerl's subtype A3 and treated with anti-gravitational casting or TLSO. The mean age of patients was 50.

A systematic review of randomised clinical trials using posterior discectomy to treat lumbar disc herniations.

The focus of this study was to examine the safety and effectiveness of three different discectomy techniques using a posterior approach for the treatment of herniated lumbar discs. There are only a small number of prospective randomised studies comparing posterior lumbar discectomy techniques, and no recent systematic review has been published on this matter. Using the Cochrane Collaboration guidelines, all randomised or "quasi-randomised" clinical trials, comparing classic, microsurgical, and endoscopic lumbar discectomies using a posterior approach were systematically reviewed.

Comparison of open discectomy with microendoscopic discectomy in lumbar disc herniations: results of a randomized controlled trial.

Objective: We compared the intra- and postoperative differences, as well as the final outcome of patients with herniated lumbar discs who underwent either open discectomy (OD) or microendoscopic discectomy (MED).

Methods: We performed a prospective controlled randomized study of 40 patients with sciatica caused by lumbar disc herniations nonresponsive to conservative treatment who underwent OD or MED with a 24-month follow-up period. Pre- and postoperative neurological status, pain, and functional outcome were evaluated.

Correlation among canal compromise, neurologic deficit, and injury severity in thoracolumbar burst fractures.

Study Design: Review the association between injury severity, narrowing of the spinal canal, and neurologic deficit in thoracolumbar burst fractures.

Objective: To determine which variable has a stronger association with neurologic deficit: spinal canal compromise or injury severity.

Summary Of Background Data: Literature has not reached a consensus regarding the cause of neurologic deficits in these fractures.