Lucas Maluf Vendas

Objective: To create and implement a structured database for patients treated by the spine surgery team at Santa Casa de Misericórdia de São Paulo, analyzing the epidemiological profile, therapeutic strategies, and clinical outcomes. Methods: Retrospective observational study including 5,085 patients treated between 2016 and 2024, comprising 4,192 outpatient consultations and 893 surgical procedures. Data were prospectively collected and recorded on the REDCap platform, including demographic information, diagnoses, treatments, clinical evolution, and standardized questionnaires. Statistical analyses were performed using R software. Results: The mean age was 46.2 ± 20.6 years, with a male predominance in outpatient care (57.8%). Low back pain and degenerative diseases were the most frequent diagnoses (26.2%), followed by lumbar disc herniation (7.6%) and thoracolumbar fractures (7.3%). In the surgical group, metastases (12.3%) and fractures (10.6%) stood out. Conservative treatment was recommended in 71.4% of outpatient cases. Among surgical patients, 47.6% underwent instrumentation, mostly via posterior approach (84.9%). The mean Oswestry Disability Index (ODI) was 31.0. Women reported higher pain intensity but showed better neurological outcomes. The surgical complication rate was 9.2%, with satisfactory evolution in 90.8% of operated cases. Conclusion: This study highlights the predominance of degenerative diseases and low back pain in outpatient settings and underscores the essential role of surgery in complex cases. The implementation of the REDCap database proved effective for clinical monitoring, contributing to the improvement of therapeutic practices and future research in spine surgery. Level of Evidence IV; Retrospective observational study.

Objective: To map obstacles in the diagnosis and treatment of early-onset scoliosis in patients treated through the Brazilian Public Health System (SUS) at a tertiary hospital in São Paulo, supporting action plans to improve treatment access. Methods: Descriptive epidemiological study with 24 patients treated between June and November 2024. Demographic variables, referral process, time to specialist consultation, and proposed treatment were analyzed. Statistical analysis included descriptive statistics for continuous and categorical variables. Normality was tested using Shapiro-Wilk, with p ≤ 0.05. This is a descriptive epidemiological study with retrospective analysis, presenting level II evidence according to the Oxford classification Results: Most patients were female, with a median age of 24 months at the initial evaluation. The most common etiology was congenital (41.7%). The mean referral time to a specialized center was 61.9 months, with 70.8% arriving via direct medical referral, without official regulation. At data collection, 37.5% were still awaiting treatment, with an average wait time of 57.4 months. Conclusion: The study highlights delays in the diagnosis and treatment of early-onset scoliosis within the public health system, impacting patient access to care. Improvements in screening, referral, and specialized resources are essential to optimize care. Level of evidence II; retrospective study.

Resumo: Objetivo Validar transculturalmente a escala de mindset da saúde para o Brasil, bem como adaptar os termos e questionários para a adequada compreensão do brasileiro, utilizando a análise fatorial como instrumento para validar a sua confiabilidade. Métodos Validação transcultural da Health Mindset Scale para o português brasileiro através do método do Beaton, cálculo do alfa de Cronbach e análise fatorial Resultados Amostra foi composta por 215 pacientes com idades entre 18 e 87 anos (M = 41,98; DP = 15,72), sendo a média de idade entre 31 e 50 anos (42,0%), e do sexo feminino (52,6%), uma diferença marginalmente significativa (p < 0,10) entre homens e mulheres foi observada para o item 3. Nesse item a média dos homens (M = 5,48; DP = 0,99) foi maior do que a média das mulheres (M = 5,10; DP = 1,22), com tamanho de efeito para diferença pequeno (d = 0,26). O coeficiente de correlação r de Pearson foi examinado entre o escore médio e a idade (r = −0,21; p = 0,002), cujo resultado indicou relação linear fraca, negativa e significativa. Quanto maior a idade, menor o escore médio na Health Mindset Scale. Conclusão A versão da escala de mindset direcionada à saúde para o português brasileiro foi apresentada e validade transculturalmente, apresentando bom coeficiente de confiabilidade – alfa de Cronbach 0,786. Sendo assim, configura novo instrumento para a prática clínica e pode ser correlacionado escalas já consagradas na literatura.