Abstract The modern human has the most flexed cranial base among all living animals. The flexure allowed a larger cranial volume to accommodate a greater brain. Spheno-occipitalis synchondrosis (SOS) has been largely responsible for cranial base flexion, between the sphenoid and the Pars basilaris of the occipital bone. The objective of this work is to evaluate the real place of skull base flexure. Analysis based on 50 magnetic resonance imaging from normal adult subjects were used to evaluate normal place for cranial base angulation (CBA). The vertex of the cranial base angle in all individuals occurred intrinsically in the sphenoid bone. In humans, cranial base flexure had a specific pre-chordal origin, rather than in the transition between pre-chordal and chordal plates and occurred in the inner sphenoidal bone.

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

RESUMO Objetivo: Avaliar a prevalência de ansiedade, depressão e cinesiofobia e sua associação com os sintomas da lombalgia. Métodos: Foram divididos 65 pacientes em três grupos: orgânicos, orgânicos amplificados e não orgânicos. Eles responderam ao Inventário de Ansiedade de Beck, Inventário de Depressão de Beck e Escala de Cinesiofobia de Tampa e foram avaliados de acordo com seu nível de dor pela Escala Análogo-Numérica. Resultados: Os escores médios de cinesiofobia dos pacientes dos grupos orgânicos, orgânicos amplificados e não orgânicos foram de 36,26, 36,21 e 23,06 pontos, respectivamente. Os pacientes que foram classificados no grupo orgânicos experimentaram maior cinesiofobia dentre os três grupos (p = 0,007). Os escores médios de ansiedade dos pacientes dos grupos orgânicos, orgânicos amplificados e não orgânicos eram de 33,17, 32,79 e 32,81 pontos, respectivamente, não houve diferença significativa entre os grupos (p = 0,99). Os escores médios de depressão dos pacientes dos grupos orgânicos, orgânicos amplificados e não orgânicos foram de 32,54, 28,79 e 37,69 pontos, respectivamente, não houve diferença significativa entre os grupos (p = 0,29). Conclusão: Não houve associação entre os grupos e a ansiedade e a depressão. No entanto, houve uma correlação positiva entre a cinesiofobia e o grupo orgânicos. São necessários estudos com outras amostras de pacientes para confirmar a reprodutibilidade e a validade desses dados em outras populações.

ABSTRACT Objective: To evaluate the prevalence of anxiety, depression and kinesiophobia and their association with the symptoms of low back pain. Methods: A total of 65 patients were divided into three groups: Organic, Amplified Organic and Non-Organic. They answered the Beck Anxiety Inventory, Beck Depression Inventory and Tampa Scale of Kinesiophobia and were evaluated according to their pain level using the Visual Analogic Scale. Results: The average kinesiophobia scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 36.26, 36.21 and 23.06 points, respectively. Patients who were classified into the Organic group experienced the most kinesiophobia out of all three groups (p = 0.007). The average anxiety scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 33.17, 32.79 and 32.81 points, respectively, with no significant difference among the groups (p = 0.99). The average depression scores of the patients in the Organic, Amplified Organic and Non-Organic groups were 32.54, 28.79 and 37.69 points, respectively, with no significant difference among the groups (p = 0.29). Conclusion: There was no association between the groups and anxiety and depression. However, there was a positive correlation between kinesiophobia and the Organic group. Studies of other patient samples are needed to confirm the reproducibility and validity of these data in other populations.