Objective: To carry out registration of patients with scoliosis under 18 years old, followed in a quarternary hospital of high complexity, who need surgical treatment, aiming to identify the reasons for the delay in treatment. Methods: Data collection was carried out in person and by spontaneous demand at the spinal orthopedic specialty outpatient clinic in a tertiary hospital of high complexity from January 2021 to December 2022. The results were compiled in the networked database (Red Cap®). Result: 59 patients were evaluated, 45 female (77.9%) and 14 male (22.1%), with a mean age of 13.7 years. Etiology: 30 idiopathic (50.8%), eight syndromic (13.5%), 11 neuromuscular (18.6%), and ten congenital (16.9%). Of the total, 46 (77.9%) were awaiting surgery and 13 (22.1%) were undergoing conservative treatment. The main causes of treatment delay: unavailability of intraoperative neurophysiological monitoring (19 - 41.3%); unavailability of specific surgical material (16 - 34.8%); difficulty of referral to our institution (6 - 13.1%); loss to follow-up (3 - 6.5%) and limitation in casting making (2 - 4.3%). The mean time between diagnosis and the first consultation is 17.25 months (0 - 140). The average surgical wait until December/2022 was 38.4 months (1 - 156). Conclusion: There is a lack of assistance in the steps of monitoring and treatment in the public health system, from directing the patient with scoliosis to the specialized center to performing the surgical procedure, mainly due to limitations in the use of intraoperative neurophysiological monitoring and the unavailability of specific materials to perform highly complex surgeries. Therapeutic Studies - Investigating the Results of Treatment.

Background: Rugby exposes athletes to high mechanical loads, especially during scrums and tackles, potentially predisposing players to early cervical spine degeneration. This study evaluated the prevalence of degenerative changes in the cervical spine and sagittal alignment alterations in Brazilian rugby athletes, with secondary analyses comparing forwards and backs and examining associations between alignment parameters and pain and disability. Methods: Sixty-four professional rugby athletes underwent cervical spine radiography, and the images were analyzed for degenerative findings and sagittal parameters (cervical lordosis, T1 slope, cervical sagittal vertical axis, and T1–CL mismatch). Pain and disability were assessed using the Visual Analogue Scale (VAS) and Neck Disability Index (NDI). Comparative analyses included Student’s t-test and Fisher’s exact test, while additional exploratory analyses were performed using correlation and multiple linear regression models. Results: Cervical degeneration was present in 20.3% of players. Forwards reported significantly greater pain than backs (VAS: 1.64 ± 1.58 vs. 0.76 ± 0.93; p = 0.007). Deviations in cervical lordosis (>2 SD from normative values) were associated with higher VAS scores (p = 0.024). No significant associations were found between T1 slope or cervical sagittal vertical axis and pain or disability. Conclusions: Forwards demonstrated greater symptom burden and a higher prevalence of cervical degenerative changes, suggesting that positional demands may contribute to early cervical spine alterations. These findings highlight the need for targeted preventive strategies and support future longitudinal investigations to clarify the progression and clinical relevance of cervical misalignment in collision-sport athletes.

Objective: To examine the evolution of degenerative changes in the vertebral plateau of patients with lumbar disc herniation undergoing microdiscectomy, emphasizing the progression of Modic type 1 and 2 changes.

Objectives: This study aimed to analyze predictive factors for postoperative complications in patients with lymphoproliferative disease in the spine.