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OBJECTIVE: To identify the patient profile that obtains better clinical and quality of life improvement after lumbar spinal stenosis surgery, comparing the results in the pre and postoperative periods. METHODS: Thirty-seven patients with lumbar spine stenosis submitted to surgery were prospectively evaluated. Through the 36-Item Short Form General Health Survey (SF-36) questionnaire we performed a preoperative analysis to identify morbidities and social security benefit earning. The SF-36 is a subjective postoperative questionnaire to assess surgical success six months after the surgery. RESULTS: There were unfavorable outcomes in patients who received social security benefits and in those who had morbidities. According to the SF-36 score, the surgical result is better when the patient is non-smoker (p=0.05), non-hypertense (p=0.040), non-diabetic (p =0.010) or non sedentary (p=0.019), respectively on mental health, pain, social aspects and general health domains. CONCLUSION: The patient profiles that best benefit from the surgery are those who do not have morbidities and had no social security benefit. Evidence Level II, Prospective Study.

RESUMEN

OBJECTIVE: To correlate spinopelvic balance with the development of degenerative spondylolisthesis and disk herniation. METHODS: This was a descriptive retrospective study that evaluated 60 patients in this hospital, 30 patients with degenerative spondylolisthesis at the L4-L5 level and 30 with herniated disk at the L4-L5 level, all of whom underwent Surgical treatment. RESULTS: Patients with lumbar disk herniation at L4-L5 level had a mean tilt of 8.06, mean slope of 36.93, and mean PI of 45. In patients with degenerative spondylolisthesis at the L4-L5 level, a mean tilt of 22.1, mean slope of 38.3, and mean PI of 61.4 were observed. CONCLUSION: This article reinforces the finding that the high mean tilt and PI are related to the onset of degenerative spondylolisthesis, and also concluded that the same angles, when low, increase the risk for disk herniation.

OBJETIVO: Correlacionar o equilíbrio espinopélvico com o desenvolvimento de espondilolistese degenerativa e hérnia discal. MÉTODOS: Estudo retrospectivo de caráter descritivo, no qual foram avaliados 60 pacientes, 30 portadores de espondilolistese degenerativa no nível L4-L5 e 30 portadores de hérnia de disco no nível L4-L5, todos submetidos a tratamento cirúrgico. RESULTADOS: Os pacientes portadores de hérnia de disco lombar no nível L4-L5 apresentaram uma média da inclinação pélvica (TILT) de 8,06, da inclinação sacral (SLOP) de 36,93 e da incidência pélvica (IP) de 45. Nos pacientes portadores espondilolistese degenerativa no nível L4-L5 foi observada uma média da TILT de 22,1, da SLOP de 38,3 e da IP de 61,4. CONCLUSÃO: O presente artigo reforça a descoberta de que as elevadas médias obtidas da TILT e da IP estão relacionadas com o surgimento da espondilolistese degenerativa e ainda conclui que os mesmos ângulos, quando baixos, aumentam o risco para hérnia de disco.

RESUMEN

OBJECTIVE: To describe the location of the dorsal root ganglion in relation to the intervertebral disc, including the "triangular" safety zone for minimally invasive surgery in the lumbar spine. METHODS: Eight adult cadavers were dissected bilaterally in the lumbar region, using a posterolateral approach, so as to expose the L3L4 and L4L5 spaces, thereby obtaining measurements relating to the space between the intervertebral disc, pedicles cranial and caudal to the disc, path of the nerve root, dorsal ganglion and safety triangle. RESULTS: The measurements obtained were constant, without significant differences between levels or any laterality. The dorsal ganglion occupied the lateral border of the triangular safety zone in all the specimens analyzed. CONCLUSION: Precise localization of the ganglion shows that the safety margin for minimally invasive procedures is less than what is presented in studies that only involve measurements of the nerve root, thus perhaps explaining the presence of neuropathic pain after some of these procedures.

OBJETIVO: Descrever a localização do gânglio da raiz dorsal em relação ao disco intervertebral, incluindo a zona "triangular"de segurança para cirurgia minimamente invasiva na coluna lombar. MÉTODOS: Oito cadáveres adultos foram dissecados bilateralmente, na região lombar, com a abordagem posterolateral, até exposição dos espaços L3L4 e L4L5 e se obtiveram medidas referentes ao espaço entre o disco intervertebral, os pedículos cranial e caudal ao disco, o trajeto da raiz nervosa, o gânglio dorsal e o triângulo de segurança. RESULTADOS: As medidas obtidas foram constantes, sem diferenças significativas entre níveis ou lateralidade. O gânglio dorsal ocupou a borda lateral da zona triangular de segurança em todos os espécimes analisados. CONCLUSÃO: A localização precisa do gânglio mostra que a margem de segurança para procedimentos minimamente invasivos é menor do que a apresentada nos estudos que envolvem apenas medidas da raiz nervosa, o que explica talvez a presença de dor neuropática após alguns desses procedimentos.

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OBJECTIVE: : To evaluate quality of life, using the SF-36, in patients with adolescent idiopathic scoliosis (AIS) who un-derwent surgery for deformity correction, comparing the results in the pre-and post-operative period. METHODS: : We evaluated 29 patients, 24 female, mean age 14.5 years, all patients had measurement of Cobb angle greater than 50º, and responded to the SF-36 questionnaire preope-ratively and on average two years after surgery. RESULTS: : There was improvement in all eight domains studied by the SF-36 after surgical treatment, with statistically significant improvement of the domains functional capacity physical aspects, pain and general state. Vitality and mental heal-th were those with the lowest percentage of improvement postoperatively. CONCLUSION: : Surgical treatment of defor-mity in all AIS improved the functional aspects assessed by the SF-36, representing, in practice, better quality of life for these patients. Evidence Level II, Prospective Study.