Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/312695
Type: TESE
Title: Avaliação do SLICS no tratamento das lesões da coluna cervical subaxial = Evaluation of the SLICS use in the treatment of subaxial cervical spine
Title Alternative: Evaluation of the SLICS use in the treatment of subaxial cervical spine
Author: Cruz, Halisson Yoshinari, 1984-
Advisor: Tedeschi, Helder, 1960-
Abstract: Resumo: Introdução: O SLICS (Subaxial Cervical Spine Injury Classification System) foi proposto para auxílio na tomada de decisão do traumatismo da coluna cervical sub-axial, contudo poucos trabalhos avaliaram sua segurança e eficácia. Método: comparar coorte histórica de pacientes tratados com base na preferência do cirurgião com pacientes tratados baseando-se no escore obtido com a aplicação do sistema. Foram incluidos pacientes com lesão traumática aguda de C3-7 com exames radiológicos e dados clínicos completos. O status neurológico foi avaliado através do ASIA Impairment Scale (AIS). Resultados: entre 2009-10, 12 pacientes foram incluídos (seguimento médio de 24,5 meses). Na admissão hospitalar 5 pacientes (41,6%) apresentavam AIS E, 1 (8,3%) AIS D, 1 (8,3%) AIS C, 1 (8,3%) AIS B e 4 (33.3%) AIS A. Dois de sete pacientes com déficit incompleto melhoraram durante o seguimento clínico. O SLICS escore variou de 2 a 9 pontos (média de 5.5 e mediana de 5.75), onde dois pacientes tinham escore menor do que 4. Entre 2011-13, 28 pacientes foram incluídos (média de 6,1 meses), com média de idade de 41,5 anos. Na admissão hospitalar 12 pacientes (42,9%) apresentavam AIS E, 4 (14,3%) AIS D, 5 (17,9%) AIS C, 2 (7,15%) AIS B e 5 (17,9%) AIS A. Seis pacientes entre os 11 com déficit incompleto apresentaram melhora. O escore de SLICS variou de 4 a 9 pontos, com média e mediana de 6. Conclusões: observamos que após a aplicação do sistema, houve uma diminuição de indicação cirúrgica nos pacientes com lesões mais estáveis ou menos graves, sem que se detectasse piora neurológica em ambos os grupos. Isso sugere que o SLICS pode ser útil para auxiliar a diferenciação das lesões mais instáveis que acometem a coluna cervical sub-axial que requeiram tratamento cirúrgico

Abstract: Introduction: The SLICS (Subaxial Cervical Spine Injury Classification System) was proposed to help in the decision-making process of surgical treatment of sub-axial cervical spine trauma, eventhough the literature assessing its safety and efficacy is scarce. Methods: we compared a cohort series of patients treated based on surgeon¿s preference with patients treated based on the SLICS. We have only included patients with acute spinal trauma from C3-7 that had complete clinical and radiological data. Results: between 2009-10, 12 patients were included (mean 24.5 months of follow-up). The preoperative AIS was: 5 patients (41.6%) were AIS E, 1 (8.3%) AIS D, 1 (8.3%) AIS C, 1 (8.3%) AIS B and 4 (33.3%) AIS A. Two out of seven patients had neurological improvement during follow-up. The SLICS score ranged from 2 to 9 points (mean of 5.5 and median of 5.75 points) with two patients with less than 4 points. From 2011-13, 28 patients were included with a SLICS (mean of 6.1 months of follow-up). The preoperative AIS was: 12 patients (42.9%) with AIS E, 4 (14.3%) AIS D, 5 (17.9%) AIS C, 2 (7.15%) AIS B and 5 (17.9%) AIS A. Six patients out of 11 had some neurological improvement. The SLICS score ranged from 4 to 9 points (mean and median of 6). There was no neurological deterioration in any group. Conclusions: after using the SLICS there was a decrease in the number of patients with less severe injuries that were treated surgically, with no reflection on neurological outcome. This suggests that the SLICS can be helpful in differentiating mild from severe injuries, potentially improving the results of treatment
Subject: Traumatismos da coluna vertebral
Language: Multilíngua
Editor: [s.n.]
Date Issue: 2015
Appears in Collections:FCM - Tese e Dissertação

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