Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla
Ano de defesa: | 2021 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de P?s-Gradua??o em Gerontologia Biom?dica
|
Departamento: |
Instituto de Geriatria e Gerontologia
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | https://tede2.pucrs.br/tede2/handle/tede/10633 |
Resumo: | Introduction: Minimally invasive surgery, through the safer access corridor to the intervertebral disc (safety triangle or Kambin's triangle), associated with the improved quality of preoperative images (nuclear magnetic resonance - NMR) provides surgeries with minimal technical damage and fast recovery. Although the surgical approach is oblique, NMR images are usually obtained from axial, sagittal, and coronal planes. Thus, the oblique plane can contribute to a better analysis of the safety triangle and the location of the dorsal root ganglion. Objectives: Compare the area and measures of the safety triangle and the location of the dorsal root ganglion in the safety triangle obtained in coronal and oblique planes in the L2-L3/L3-L4/L4-L5 levels in patients submitted to 3 Tesla NMR. Methods: An observational study with a convenience sample including 210 patients over 18 years old, obtained from the records of 3 Tesla lumbar spine NMR scan and performed at the Brain Institute of Rio Grande do Sul (InsCer) from December 2017 to December 2020. Scans with lumbar spine anomalies were excluded. The demographic variables studied were sex, age group, and radiological variables obtained from NMR images [dimensions/location assessed: height of the safety triangle (mm)= formed by the lateral edge of the dura-mater; base of the safety triangle (mm)= formed upper plateau of the lower vertebra; hypotenuse of the safety security (mm)= formed by the corresponding nerve root; safety triangle area (mm3); dimensions and location of the ganglion in the safety triangle (mm)]. Data collection was obtained by a single researcher, on the right side, through reconstruction in maximum intensity projection, with an increase of 0.5 mm, thickness of 5 mm and inclination of 30 degrees in the oblique plane. Results: The mean age of the sample was 45.5?13.3 years (18-98 years), most female (57.1%). The mean of the dimensions, as well as the area, gradually increased from L2 to L5 in both planes. Women had significantly lower values in 19 of the 21 dimensions obtained in the coronal plane and in 17 dimensions obtained in the oblique plane in relation to male sex. Regarding the age group, only 5 of the 42 dimensions obtained with coronal and oblique planes were significantly higher in the 40-65 years age group compared to the 18-39 years age group. The mean area of the safety triangle was lower in the oblique plane compared to coronal plane in all studied levels. From the seven dimensions of the safety triangle obtained for each level of the lumbar spine, six were significantly smaller in the oblique plane in relation to the coronal plane. The smallest ganglion dimension was the only dimension that showed no difference. Conclusion: The dimensions of the safety triangle in the oblique plane were smaller concerning the coronal plane. Therefore, the oblique plane of NMR images was indicated as an important tool in the preoperative assessment, as it represents the most reliable surgical access corridor to the disc, increasing the safety of these procedures. |
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Schwanke, Carla Helena Augustinhttp://lattes.cnpq.br/2584101236741703http://lattes.cnpq.br/1659343861998398Dannebrock, Fernando Augusto2023-02-17T20:46:07Z2021-03-18https://tede2.pucrs.br/tede2/handle/tede/10633Introduction: Minimally invasive surgery, through the safer access corridor to the intervertebral disc (safety triangle or Kambin's triangle), associated with the improved quality of preoperative images (nuclear magnetic resonance - NMR) provides surgeries with minimal technical damage and fast recovery. Although the surgical approach is oblique, NMR images are usually obtained from axial, sagittal, and coronal planes. Thus, the oblique plane can contribute to a better analysis of the safety triangle and the location of the dorsal root ganglion. Objectives: Compare the area and measures of the safety triangle and the location of the dorsal root ganglion in the safety triangle obtained in coronal and oblique planes in the L2-L3/L3-L4/L4-L5 levels in patients submitted to 3 Tesla NMR. Methods: An observational study with a convenience sample including 210 patients over 18 years old, obtained from the records of 3 Tesla lumbar spine NMR scan and performed at the Brain Institute of Rio Grande do Sul (InsCer) from December 2017 to December 2020. Scans with lumbar spine anomalies were excluded. The demographic variables studied were sex, age group, and radiological variables obtained from NMR images [dimensions/location assessed: height of the safety triangle (mm)= formed by the lateral edge of the dura-mater; base of the safety triangle (mm)= formed upper plateau of the lower vertebra; hypotenuse of the safety security (mm)= formed by the corresponding nerve root; safety triangle area (mm3); dimensions and location of the ganglion in the safety triangle (mm)]. Data collection was obtained by a single researcher, on the right side, through reconstruction in maximum intensity projection, with an increase of 0.5 mm, thickness of 5 mm and inclination of 30 degrees in the oblique plane. Results: The mean age of the sample was 45.5?13.3 years (18-98 years), most female (57.1%). The mean of the dimensions, as well as the area, gradually increased from L2 to L5 in both planes. Women had significantly lower values in 19 of the 21 dimensions obtained in the coronal plane and in 17 dimensions obtained in the oblique plane in relation to male sex. Regarding the age group, only 5 of the 42 dimensions obtained with coronal and oblique planes were significantly higher in the 40-65 years age group compared to the 18-39 years age group. The mean area of the safety triangle was lower in the oblique plane compared to coronal plane in all studied levels. From the seven dimensions of the safety triangle obtained for each level of the lumbar spine, six were significantly smaller in the oblique plane in relation to the coronal plane. The smallest ganglion dimension was the only dimension that showed no difference. Conclusion: The dimensions of the safety triangle in the oblique plane were smaller concerning the coronal plane. Therefore, the oblique plane of NMR images was indicated as an important tool in the preoperative assessment, as it represents the most reliable surgical access corridor to the disc, increasing the safety of these procedures.Introdu??o: A cirurgia minimamente invasiva, atrav?s do corredor de acesso mais seguro ao disco intervertebral (tri?ngulo de seguran?a ou tri?ngulo de Kambin), associada a melhora na qualidade de imagens pr?-operat?rias (resson?ncia nuclear magn?tica ? RNM) proporcionam cirurgias com dano tecidual m?nimo e r?pida recupera??o. Contudo, apesar da abordagem cir?rgica ser obl?qua, as imagens de RNM s?o usualmente obtidas nas incid?ncias axial, sagital e coronal. Assim, a incid?ncia obliqua pode contribuir para uma melhor an?lise do tri?ngulo de seguran?a e da localiza??o do g?nglio da raiz dorsal. Objetivos: comparar a ?rea e as medidas do tri?ngulo de seguran?a e a localiza??o do g?nglio da raiz dorsal no tri?ngulo de seguran?a obtidas nas incid?ncias coronal e obl?qua nos n?veis L2-L3/L3-L4/L4-L5 em pacientes submetidos ? Resson?ncia Nuclear Magn?tica 3.0 Tesla. M?todos: Estudo observacional cuja amostra, de conveni?ncia, incluiu 210 pacientes maiores de 18 anos e foi obtida a partir dos registros dos exames RNM de coluna lombar 3 Tesla realizadas no Instituto do C?rebro do Rio Grande do Sul (InsCer) no per?odo de dezembro de 2017 a dezembro de 2020. Foram exclu?dos exames com anomalias da coluna lombar. As vari?veis demogr?ficas estudadas foram sexo, idade/faixa et?ria e vari?veis radiol?gicas obtidas nas imagens de RNM [dimens?es/localiza??o avaliadas: altura do tri?ngulo de seguran?a (mm)= formada pela borda lateral da dura-m?ter; base do tri?ngulo de seguran?a (mm)= formada pelo plat? superior da v?rtebra inferior; hipotenusa do tri?ngulo de seguran?a (mm)= formada pela raiz nervosa correspondente; ?rea do tri?ngulo de seguran?a (mm3); dimens?es e localiza??o do g?nglio no tri?ngulo de seguran?a (mm)]. A coleta dos dados foi feita por um ?nico avaliador, no lado direito, atrav?s de reconstru??o em proje??o de intensidade m?xima, com incremento de 0,5 mm, espessura de 5 mm e inclina??o de 30 graus no plano obl?quo. Resultados: A m?dia de idade da amostra foi de 45,5?13,3 anos (18-98 anos), sendo a maioria do sexo feminino (57,1%). A m?dia das dimens?es, assim como a ?rea, aumentaram gradualmente de L2 a L5 em ambas as incid?ncias. As mulheres apresentaram valores significativamente menores em 19 das 21 dimens?es obtidas na incid?ncia coronal e em 17 dimens?es obtidas na incid?ncia obl?qua em rela??o ao sexo masculino. Em rela??o as faixas et?rias, somente 5 das 42 dimens?es obtidas nas incid?ncias coronal e obliqua foram significativamente maiores no grupo de 40-65 anos em rela??o ao grupo 18-39 anos. A m?dia da ?rea do tri?ngulo de seguran?a foi menor na incid?ncia obl?qua em rela??o ? incid?ncia coronal em todos os n?veis estudados. Das sete dimens?es do tri?ngulo de seguran?a obtidas para cada n?vel da coluna lombar, seis foram significativamente menores no plano obl?quo em rela??o ao plano coronal. A ?nica dimens?o que n?o apresentou diferen?a foi a menor dimens?o do g?nglio. Conclus?o: As dimens?es do tri?ngulo de seguran?a na incid?ncia obl?qua foram menores em rela??o ? incid?ncia coronal. Assim sendo, a incid?ncia obl?qua das imagens de RNM mostrou-se uma ferramenta importante na avalia??o pr?-operat?ria, pois traduz o corredor de acesso cir?rgico mais fidedigno ao disco, o que aumenta a seguran?a destes procedimentos.Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2023-02-15T12:39:19Z No. of bitstreams: 1 DANNEBROCK_FERNANDO_DIS .pdf: 4505918 bytes, checksum: 399bc7dd566539c4b06702cae961c8d6 (MD5)Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2023-02-17T20:38:46Z (GMT) No. of bitstreams: 1 DANNEBROCK_FERNANDO_DIS .pdf: 4505918 bytes, checksum: 399bc7dd566539c4b06702cae961c8d6 (MD5)Made available in DSpace on 2023-02-17T20:46:07Z (GMT). No. of bitstreams: 1 DANNEBROCK_FERNANDO_DIS .pdf: 4505918 bytes, checksum: 399bc7dd566539c4b06702cae961c8d6 (MD5) Previous issue date: 2021-03-18Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPESapplication/pdfhttps://tede2.pucrs.br/tede2/retrieve/186551/DIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Gerontologia Biom?dicaPUCRSBrasilInstituto de Geriatria e GerontologiaImagem por Resson?ncia Magn?ticaRa?zes Nervosas EspinhaisProcedimentos Cir?rgicos Minimamente InvasivosColuna VertebralAnatomiaG?nglios EspinaisMagnetic Resonance ImagingSpinal Nerve RootsMinimally Invasive Surgical ProceduresSpineAnatomySpinal GangliaCIENCIAS DA SAUDE::MEDICINATri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 teslainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisTrabalho ser? publicado como artigo ou livro60 meses17/02/202889696450708863641605005005006002296420844541114010-9693694523087866273590462550136975366info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILDIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf.jpgDIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf.jpgimage/jpeg4138https://tede2.pucrs.br/tede2/bitstream/tede/10633/4/DIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf.jpgda693550a1c190b40cad564ac279b6b2MD54TEXTDIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf.txtDIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf.txttext/plain1980https://tede2.pucrs.br/tede2/bitstream/tede/10633/3/DIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf.txtc69b31bcae1b4c24a962e990c10f9d07MD53ORIGINALDIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdfDIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdfapplication/pdf752821https://tede2.pucrs.br/tede2/bitstream/tede/10633/2/DIS_FERNANDO_AUGUSTO_DANNEBROCK_CONFIDENCIAL.pdf17c9dfc92dd478f42dafb84f81204e7eMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590https://tede2.pucrs.br/tede2/bitstream/tede/10633/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/106332023-02-18 12:00:15.757oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2023-02-18T14:00:15Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla |
title |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla |
spellingShingle |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla Dannebrock, Fernando Augusto Imagem por Resson?ncia Magn?tica Ra?zes Nervosas Espinhais Procedimentos Cir?rgicos Minimamente Invasivos Coluna Vertebral Anatomia G?nglios Espinais Magnetic Resonance Imaging Spinal Nerve Roots Minimally Invasive Surgical Procedures Spine Anatomy Spinal Ganglia CIENCIAS DA SAUDE::MEDICINA |
title_short |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla |
title_full |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla |
title_fullStr |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla |
title_full_unstemmed |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla |
title_sort |
Tri?ngulo de seguran?a lombar : estudo comparativo das incid?ncias coronais e obl?quas em resson?ncia nuclear magn?tica 3 tesla |
author |
Dannebrock, Fernando Augusto |
author_facet |
Dannebrock, Fernando Augusto |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Schwanke, Carla Helena Augustin |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/2584101236741703 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/1659343861998398 |
dc.contributor.author.fl_str_mv |
Dannebrock, Fernando Augusto |
contributor_str_mv |
Schwanke, Carla Helena Augustin |
dc.subject.por.fl_str_mv |
Imagem por Resson?ncia Magn?tica Ra?zes Nervosas Espinhais Procedimentos Cir?rgicos Minimamente Invasivos Coluna Vertebral Anatomia G?nglios Espinais |
topic |
Imagem por Resson?ncia Magn?tica Ra?zes Nervosas Espinhais Procedimentos Cir?rgicos Minimamente Invasivos Coluna Vertebral Anatomia G?nglios Espinais Magnetic Resonance Imaging Spinal Nerve Roots Minimally Invasive Surgical Procedures Spine Anatomy Spinal Ganglia CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Magnetic Resonance Imaging Spinal Nerve Roots Minimally Invasive Surgical Procedures Spine Anatomy Spinal Ganglia |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Introduction: Minimally invasive surgery, through the safer access corridor to the intervertebral disc (safety triangle or Kambin's triangle), associated with the improved quality of preoperative images (nuclear magnetic resonance - NMR) provides surgeries with minimal technical damage and fast recovery. Although the surgical approach is oblique, NMR images are usually obtained from axial, sagittal, and coronal planes. Thus, the oblique plane can contribute to a better analysis of the safety triangle and the location of the dorsal root ganglion. Objectives: Compare the area and measures of the safety triangle and the location of the dorsal root ganglion in the safety triangle obtained in coronal and oblique planes in the L2-L3/L3-L4/L4-L5 levels in patients submitted to 3 Tesla NMR. Methods: An observational study with a convenience sample including 210 patients over 18 years old, obtained from the records of 3 Tesla lumbar spine NMR scan and performed at the Brain Institute of Rio Grande do Sul (InsCer) from December 2017 to December 2020. Scans with lumbar spine anomalies were excluded. The demographic variables studied were sex, age group, and radiological variables obtained from NMR images [dimensions/location assessed: height of the safety triangle (mm)= formed by the lateral edge of the dura-mater; base of the safety triangle (mm)= formed upper plateau of the lower vertebra; hypotenuse of the safety security (mm)= formed by the corresponding nerve root; safety triangle area (mm3); dimensions and location of the ganglion in the safety triangle (mm)]. Data collection was obtained by a single researcher, on the right side, through reconstruction in maximum intensity projection, with an increase of 0.5 mm, thickness of 5 mm and inclination of 30 degrees in the oblique plane. Results: The mean age of the sample was 45.5?13.3 years (18-98 years), most female (57.1%). The mean of the dimensions, as well as the area, gradually increased from L2 to L5 in both planes. Women had significantly lower values in 19 of the 21 dimensions obtained in the coronal plane and in 17 dimensions obtained in the oblique plane in relation to male sex. Regarding the age group, only 5 of the 42 dimensions obtained with coronal and oblique planes were significantly higher in the 40-65 years age group compared to the 18-39 years age group. The mean area of the safety triangle was lower in the oblique plane compared to coronal plane in all studied levels. From the seven dimensions of the safety triangle obtained for each level of the lumbar spine, six were significantly smaller in the oblique plane in relation to the coronal plane. The smallest ganglion dimension was the only dimension that showed no difference. Conclusion: The dimensions of the safety triangle in the oblique plane were smaller concerning the coronal plane. Therefore, the oblique plane of NMR images was indicated as an important tool in the preoperative assessment, as it represents the most reliable surgical access corridor to the disc, increasing the safety of these procedures. |
publishDate |
2021 |
dc.date.issued.fl_str_mv |
2021-03-18 |
dc.date.accessioned.fl_str_mv |
2023-02-17T20:46:07Z |
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info:eu-repo/semantics/publishedVersion |
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masterThesis |
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https://tede2.pucrs.br/tede2/handle/tede/10633 |
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https://tede2.pucrs.br/tede2/handle/tede/10633 |
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por |
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8969645070886364160 |
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2296420844541114010 |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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Programa de P?s-Gradua??o em Gerontologia Biom?dica |
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PUCRS |
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Brasil |
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Instituto de Geriatria e Gerontologia |
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Pontif?cia Universidade Cat?lica do Rio Grande do Sul |
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