RESUMO
Major manifestations of vertebral degenerative joint disease were observed on a Pre-Columbian Muisca series from the Soacha Cemetery (11th to 13th centuries) Colombia, South America. In total, 1,646 vertebrae of 83 individuals were examined. Osteophytes, vertebral body joint surface contour change ("lipping"), and vertebral body pitting were evaluated for each vertebral body. For apophyseal joints, joint surface contour change, pitting, and eburnation were recorded. Two methods of frequency calculation and five for vertebral degenerative disease diagnosis were applied and compared, allowing discussion of methodological considerations. Our study showed that 83% of individuals and 32% of vertebrae were classified as positive when diagnosed by the presence of at least one of the following manifestations: osteophytes, vertebral body joint surface contour change ("lipping"), apophyseal joint surface contour change, or eburnation (method called "Pitting excluded"). No significant differences were found between the sexes. In the youngest cohort (15-30 years), 65% of individuals and 10% of vertebrae exhibit at least one of the previously mentioned manifestations. High prevalences suggest a high level of physical activity beginning in childhood which may have accelerated the aging process in this Pre-Columbian population. Historical data are compatible with this hypothesis.
Assuntos
Indígenas Sul-Americanos/história , Artropatias/diagnóstico , Artropatias/epidemiologia , Artropatias/patologia , Osteofitose Vertebral/patologia , Coluna Vertebral/patologia , Fatores Etários , Colômbia/epidemiologia , Feminino , História Medieval , Humanos , Artropatias/complicações , Masculino , Prevalência , Osteofitose Vertebral/etiologiaRESUMO
BACKGROUND: Low back pain often affects the economically active population with repercussions in world productivity. MRI defines the diagnosis easily with high specificity, allowing the most adequate treatment to be initiated. We undertook this study to confirm the diagnostic sensitivity and specificity of MRI in the evaluation of degenerative lumbosacral disease with facet joint participation. METHODS: In a 6-month period we studied 358 patients with low back pain and/or sciatica due to degenerative disorders. We performed a basic evaluation on the clinical characteristics of pain. Plain sequences (T1 and T2) were used on axial, sagittal and coronal planes with MR equipment (0.5 T), evaluating the degenerative modifications of the lumbosacral region. RESULTS: Discal degeneration associated with multidirectional bulging of annulus and extrusion and protrusion of discal material affected mostly L4-L5 and L5-S1 levels. The same levels showed most degenerative changes on facet joints. The most relevant result in our study was articular facet joint disease present in all cases regardless of the association with intervertebral osteochondrosis, discal hernia and spinal stenosis. CONCLUSIONS: Diagnostic value of MRI in the study of low back pain offers a reliable evaluation with high sensitivity and specificity, in order to make appropriate therapeutic decisions.
Assuntos
Imageamento por Ressonância Magnética , Osteofitose Vertebral/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Dor Lombar/diagnóstico , Dor Lombar/etiologia , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoartrite/complicações , Osteoartrite/diagnóstico , Radiografia , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Osteofitose Vertebral/etiologiaRESUMO
Objetivos: evaluar los resultados obtenidos en pacientes con radiculopatía cervical espondilótica o discal operados mediante abordaje cervical posterolateral. Métodos: desde octubre de 1994 a enero de 1998, 30 pacientes consecutivos fueron intervenidos quirúrgicamente mediante foraminotomía posterior por cuadros de radiculopatía cervical. Hubo 23 hombres y 7 mujeres, con un promedio de 41 años. El seguimiento promedio fue de 64 semanas. Los resultados fueron analizados mediante los criterios de Odom y la escala semi-análoga. Resultados: al seguimiento el 90 por ciento de los pacientes tuvieron recuperación completa o habían mejorado considerablemente su condición prequirúrgica. Conclusión: usando estrictos criterios de selección, el abordaje posterolateral permite obtener excelentes resultados en la radiculopatía cervical espondilótica o discal, con escasa morbilidad
Assuntos
Humanos , Masculino , Feminino , Adulto , Doenças do Sistema Nervoso Periférico/cirurgia , Doenças do Sistema Nervoso Periférico/etiologia , Forame Magno/cirurgia , Sinais e Sintomas , Osteofitose Vertebral/etiologia , Osteofitose Vertebral/cirurgia , Resultado do TratamentoRESUMO
Os autores apresentam um caso com alteraçöes típicas da disostose espôndilo-costal (malformaçäo atingindo a coluna em toda a sua extensäo, sendo toda ela constituída praticamente de hemivértebras e com malformaçäo costal), filho único de pais consangüineos (primos em 2§ grau). Discutem os aspectos etiopatogênicos, a heterogeneidade da doença e as dificuldades do aconselhamento genético