Papers by Asdrubal Falavigna
Coluna/ …, 2010
INTRODUÇÃO: a hérnia de disco lombar (HDL) é uma patologia prevalente na atualidade, que acarreta... more INTRODUÇÃO: a hérnia de disco lombar (HDL) é uma patologia prevalente na atualidade, que acarreta limitações físicas, psiquícas e sociais ao paciente. Os sinais e sintomas mais frequentes são lombociatalgia, distúrbios motores e sensitivos e sinal de Lasègue. Nos pacientes com HDL refrátarios ao tratamento clínico, microdiscectomia é o procedimento padrão para a melhora dos sintomas. OBJETIVOS: estudar a relevância prognóstica dos sinais e sintomas nos pacientes com HDL refratários ao tratamento clínico. MÉTODOS: foram pesquisados, nas principais bases de dados biomédicas, os artigos que estudaram a percentagem de melhora e o valor prognóstico dos sinais e sintomas pré-operatórios dos pacientes com HDL. Os sinais e os sintomas avaliados foram dor lombar, dor na perna, distúrbios motores e sensitivos e sinal de Lasègue. CONCLUSÃO: o índice de sucesso da cirurgia dos pacientes com HDL refratários ao tratamento clínico correlaciona-se com a ausência de lombalgia, a presença de ciatalgia com tempo de evolução de até 6 meses, o déficit sensitivo presente de forma isolada ou associado ao déficit motor e a presença de sinal de Lasègue positivo no período pré-operatório.
The objectives of spinal surgery for degenerative disorders are to reduce pain and disability and... more The objectives of spinal surgery for degenerative disorders are to reduce pain and disability and improve pa-tients' quality of life while allowing an early return to work. The incongruence between surgeons' perspectives, findings of imaging exams in terms of fusion statuses or adequate decompression, and patients' satisfaction levels with treatment have underscored the need to evaluate outcomes of spinal surgery with a specific focus on patients' perspectives. Patient-reported outcomes (PRO) are reports on health status taken directly from patients without interference from physicians. In recent decades, several generic and disease-specific PRO instruments have been developed and validated in patients with spinal disorders. In this paper, we review the most commonly used PRO instruments in patients with spinal disorders, focussing on their characteristics, applicability and minimum clinically important differences.
Arquivos de Neuro-Psiquiatria, 2004
We present a case of trigeminal neuralgia with cranial normal magnetic resonance image (MRI) and ... more We present a case of trigeminal neuralgia with cranial normal magnetic resonance image (MRI) and computed tomography. The pain was not relieved by carbamazepine and microvascular decompression surgery was done. After two months the pain was similar to the condition before surgery. At this time, MRI showed an expansive lesion in Meckel's cave that was treated with radical resection by extra-dural approach. The pathologic examination revealed a primary melanoma. The follow-up after six months did not show abnormalities.
Arquivos de neuro-psiquiatria, 2006
Spinal cord injury without radiologic abnormalities is a rare condition that occurs more frequent... more Spinal cord injury without radiologic abnormalities is a rare condition that occurs more frequently in children and contributes to a high rate of morbidity among these patients. We report the case of a five-month-old infant, victim of automobile accident, who was brought to our service with a sensitive level in T2 and bilateral crural paraplegia. Radiographic exams and computed tomography of spine did not evidence of bone or ligaments injuries. Magnetic resonance image showed complete spinal cord transection and spine avulsion in the segment between T3 and T7. We discuss this pathology according to its epidemiology, pathophysiology, diagnosis, treatment and prognostic aspects.
Arquivos De Neuro-psiquiatria, 2004
Germ cell tumors are originated from the primary stem cell located either in or outside the gonad... more Germ cell tumors are originated from the primary stem cell located either in or outside the gonadal system. Teratomas are the major group, with the sacrococcygeal location being the most common extragonadal site, independent they are benign or malignant. We describe three cases of sacrococcygeal teratoma and emphasize aspects of diagnosis, surgical techniques and complementary approaches.
Arquivos De Neuro-psiquiatria, 2002
RESUMO -Objetivo: Apresentamos resultados da estimulação contínua do núcleo ventral intermédio (V... more RESUMO -Objetivo: Apresentamos resultados da estimulação contínua do núcleo ventral intermédio (VIM) talâmico para o controle do tremor. Método: Quatro pacientes foram selecionados no período de outubro de 1999 a janeiro de 2001 com tremor incapacitante refratário à farmacoterapia. Dois pacientes apresentavam tremor essencial (TE) bilateral e 2 pacientes tremor de repouso por doença de Parkinson (DP), um à direita e outro à esquerda. Após avaliação sistemática, foram submetidos ao implante de eletrodo talâmico, modelo DBS 3387(Medtronic), para estimulação cerebral profunda (ECP) com alta frequência, sendo este bilateral nos casos de TE e unilateral nos casos com tremor por DP. Resultados: Os pacientes tiveram seu seguimente clínico até o presente, com média de 12 meses, sendo observada a eficácia da estimulação do núcleo VIM no controle dos disparos das células do tremor. As complicações temporárias do tipo parestesias, disartrias e discreto aumento do tônus foram revertidas após o ajuste dos parâmetros de estimulação. Conclusão: Os resultados confirmam os achados da literatura, de que a estimulação talâmica é excelente opção terapêutica no tratamento do tremor, havendo possibilidade de estimulação talâmica bilateral simultânea com segurança.
Spine, Jan 18, 2013
Study Design. Retrospective cohort study.Objective. The purpose of this study was to report the n... more Study Design. Retrospective cohort study.Objective. The purpose of this study was to report the neurological presentation, outcome and surgical planning in a series of patients with a symptomatic single level C7-T1 disc herniation who underwent anterior surgical discectomy and fusion.Summary of Background Data. Disc herniations at C7-T1 are uncommon and there are few large series in the literature describing anterior treatment of such herniations.Methods. We performed a retrospective study of patients who underwent surgery for a C7-T1 disc herniation and reviewed the medical records, operative reports, and imaging studies. The surgeons' view line was drawn and its relation to the manubrium and the great vessels was determined on T1 sagittal magnetic resonance imaging (MRI). The location of the herniated disc in the spinal canal was determined using a T2 axial MRI and classified as central, foraminal and central/foraminal. Loss of muscle strength was evaluated preoperatively and ...
Journal of Epilepsy and Clinical Neurophysiology, 2009
To evaluate the awareness on epilepsy among undergraduate health care students in a private unive... more To evaluate the awareness on epilepsy among undergraduate health care students in a private university. Methods: A self-administered questionnaire about epilepsy was applied to 417 students at Universidade de Caxias do Sul. The answers were analyzed in two groups: group 1, medical and nursing students; group 2, psychology, physiotherapy and nutrition students. Results: Most of the students were familiar with the disease. Although many of them recognize brain disease as a cause of seizure, it was observed that a quarter of them linked epilepsy with mental disease. Besides, a relevant portion of the sample presents mistaken attitudes on seizure management. Conclusion: There is lack of information on epilepsy among these students. The students and the health care professionals are important vectors of information. Therefore, further discussion on this subject is necessary in health care training to demystify some aspects concerning the disease.
Spine, 2014
Retrospective cohort study. The purpose of this study was to report the neurological presentation... more Retrospective cohort study. The purpose of this study was to report the neurological presentation, outcome and surgical planning in a series of patients with a symptomatic single-level C7-T1 disc herniation who underwent anterior surgical discectomy and fusion. Disc herniations at C7-T1 are uncommon, and there are few large series in the literature describing anterior treatment of such herniations. We performed a retrospective study of patients who underwent surgery for a C7-T1 disc herniation and reviewed the medical records, operative reports, and imaging studies. The surgeons' view line was drawn and its relation to the manubrium and the great vessels was determined on T1 sagittal magnetic resonance imaging. The location of the herniated disc in the spinal canal was determined using a T2 axial magnetic resonance imaging and classified as central, foraminal, and central/foraminal. Loss of muscle strength was evaluated preoperatively and at the last follow-up according to the classification of the Medical Research Council. The disc space was approached anteriorly by a standard cervical supramanubrial Smith-Robinson approach. We identified 19 patients who had undergone C7-T1 discectomy and fusion. The mean age of the sample was 54.26 ± 8.65 years. There was a higher proportion of male patients (57.9%, 11/19). The clinical presentation was predominantly motor deficit in 15/19 cases (78.9%) in intrinsic hand muscles, and usually improved after surgery. The mean follow-up period was 27.05 ± 15.10 months. All the patients underwent an anterior cervical supramanubrial approach with microdiscectomy and fusion. Anterior cervical plate fixation was used in 9/19 cases (47.3%). In the rest of the cases, a stand-alone intervertebral device was placed. An anterior cervical supramanubrial approach was easily accomplished in all patients. Motor deficit was the most common surgical indication. 4.
Journal of neurosurgery. Pediatrics, 2014
OBJECT.: A previous study published by the authors showed that a single intervention could not ch... more OBJECT.: A previous study published by the authors showed that a single intervention could not change the baseline attitudes toward neurotrauma prevention. The present study was designed to evaluate the effectiveness of multiple interventions in modifying knowledge and attitudes for the prevention of neurotrauma in Brazilian preteens and adolescents. In a randomized controlled trial, fifth-year primary school (PS) and second-year high school (HS) students were divided into a control and 2 intervention (single/multiple) groups. The study was conducted in the following 8 stages: T1, questionnaire to measure baseline characteristics; T2, lecture on trauma prevention; T3, reapplying the questionnaire used in T1; T4, Traffic Department intervention; T5, a play about trauma and its consequences; T6, Fire Department intervention; T7, Emergency Medical Service intervention; and T8, reapplying the questionnaire used in T1 and T3. Positive answers were considered those affirming the use of sa...
Spine, 2015
Cross-sectional study. To assess the prevalence and the general characteristics of low back pain ... more Cross-sectional study. To assess the prevalence and the general characteristics of low back pain (LBP) in a middle-aged population living in southern Brazil. LBP is a widespread musculoskeletal condition. It is the main cause of disability in developed countries. It is necessary and relevant to study the risk factors for LBP to plan preventative action. A cross-sectional study of a middle-aged population in the South of Brazil was designed to look at the prevalence and general characteristics of LBP. A cross-sectional study was developed in a city located in southern Brazil. Data were collected from 1005 individuals at randomized public locations. A protocol was designed to evaluate the general characteristics of the population: age, sex, level of education, socioeconomic status, body mass index, occupation, smoking, physical activity, anxiety, and depression. After the initial evaluation, the individuals were asked if they had had low back pain at least once in their lifetime. Those who answered "Yes" continued the questionnaire that evaluated pain intensity, characteristics, and related disability. After the entire group was analyzed (N = 1005), a separate study was performed on the participants younger than 40 years (N = 701). The mean age was 33.74 years (±14.76) and 61.6% of the participants were females. Seventy-two percent of the participants had had LBP at least once in their lives. The mean of visual analogue scale intensity of pain was 4.51 (±2.27). The prevalence of female sex (P = 0.006) and anxiety (P < 0.001) was higher in those with LBP. In the group younger than 40 years, the prevalence of LBP was 69.7% and anxiety (P < 0.001) was the only factor related to LBP. Low back pain is a highly prevalent condition in a middle-aged population living in southern Brazil. Higher levels of anxiety and female sex were related to this condition in all groups, but when it was analyzed in the participants younger than 40 years, anxiety was the only significant variable related with LBP. 3.
Arquivos De Neuro-psiquiatria, 2004
Coluna/Columna, 2013
ABSTRACT Surgical experiments with laboratory animals are necessary for medical research. These s... more ABSTRACT Surgical experiments with laboratory animals are necessary for medical research. These studies aim to clarify the mechanism of disease, investigate the action and efficacy of new drugs or biological markers, as well as develop and enhance new therapies and apply new techniques. Regarding the models of spinal cord injury (SCI), there are several different methods that address the handling of the animals, especially concerning the use of analgesics, antibiotics and pre- and postoperative management. The lack of uniformity and standardization among the studies does not allow the understanding of the model of SCI or the proper handling of the paraplegic animals, hampering the adequate interpretation and comparison of results. The goal of this study is to establish a standard protocol on the handling of animals subjected to experimental models of SCI.
Spine, 2009
Objective. To evaluate the efficacy of hydroxyapatite (HA) grafts in combination with cervical pl... more Objective. To evaluate the efficacy of hydroxyapatite (HA) grafts in combination with cervical plates in terms of fusion, restoration, and maintenance of cervical lordosis and to compare clinical and radiologic outcomes of patients who experienced graft breakage with patients who did not.
Sleep and Breathing, 2011
Purpose Sleep disorders are very common in the young, being a result of the typical lifestyle liv... more Purpose Sleep disorders are very common in the young, being a result of the typical lifestyle lived by young people or a sleep disease that requires assistance and treatment. Furthermore, according to previous findings, sleep alterations can favor the development of depressive mood disorder. This survey aimed to assess the prevalence and characteristics of sleep disorders in a young population sample and their association with depressive symptoms. Methods With a cross-sectional study design, selfadministered questionnaires were applied to 1,180 undergraduate students. The Mini-Sleep Questionnaire (MSQ) and the Beck Depression Inventory were used to evaluate sleep disturbances and depressive symptoms, respectively. Bivariate and multivariate analyses were conducted, with the main findings being the presence of disrupted sleep (MSQ > 24), with an alpha error of 5%. The median point of the MSQ was 26 (P25-P75, 21-32 points).
Sleep and Breathing, 2011
PLoS ONE, 2014
Background: Despite the small contribution of LA in the Science Citation Index (SCI), a growing c... more Background: Despite the small contribution of LA in the Science Citation Index (SCI), a growing contribution by LA research to international literature has been observed in recent years.
Journal of Neurosurgery: Spine, 2011
Uploads
Papers by Asdrubal Falavigna