Browsing by Author "Falavigna, Asdrubal"
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Item Management of type II odontoid fractures: experience from latin american spine centers(Elsevier, 2017) Falavigna, Asdrubal; Righesso, Orlando; Guarise da Silva, Pedro; Rocca Siri, Carlos; Daniel, Jefferson; Esteves Veiga, Jose Carlos; Borges Laurindo de Azevedo, Gustavo; Carelli, Luis Eduardo; Yurac, Ratko; Sanchez Chavez, Felix Adolfo; Sfreddo, Ericson; Cecchini, Andre; Martins do Reis, Marcelo; Jimenez Avila, Jose Maria; Riew, DanielOBJECTIVE: To analyze characteristics of type II odontoid fracture (TII-OF), including clinical and radiographic factors, that influence surgical planning in 8 Latin American centers. METHODS: Retrospective chart review was performed of 88 patients with TII-OF between 2004 and 2015 from 8 Latin American centers. Parameters studied included 1) demographic data and causes of TII-OF, 2) clinical and neurologic presentation, 3) characteristics of fracture (degree of odontoid displacement, displacement of odontoid relative to C2 body, anatomy of fracture line, distance between fragments, presence of comminution, contact area between odontoid and C2 body), 4) type of treatment, and 5) clinical and radiographic outcome. Bone fusion was assessed using computed tomography. RESULTS: Mean patient age was 45.33 years ± 23.54; 78.4% of patients were male. Surgery was the primary treatment in 65 patients (73.8%), with an anterior approach in 64.6%. Surgery was usually preferred in patients with posterior or horizontal oblique fracture lines, local pain, and a smaller bone contact surface between the odontoid and the body of C2. A posterior approach was chosen when distance between the fractured bone fragments was >2 mm or after failed conservative or anterior odontoid screw treatment in a symptomatic patient. CONCLUSION: The treatment of choice for TII-OF in 8 Latin American trauma centers was surgery through an anterior approach using screw fixation. Posterior segmental C1-C2 fixation was indicated when distance between bone fragments was >2 mm and in symptomatic patients with nonunion.Item Time to Surgery for Unstable Thoracolumbar Fractures in Latin America—A Multicentric Study(2021) Guiroy, Alfredo; Carazzo, Charles; Zamorano, Juan; Cabrera, Juan; Joaquim, Andrei; Guasque, Joana; Sfredo, Ericson; White, Kevin; Yurac, Ratko; Falavigna, AsdrubalObjective We sought to identify delays for surgery to stabilize unstable thoracolumbar fractures and the main reasons for them across Latin America. Methods We reviewed the charts of 547 patients with type B or C thoracolumbar fractures from 21 spine centers across 9 Latin American countries. Data were collected on demographics, mechanism of trauma, time between hospital arrival and surgery, type of hospital (public vs. private), fracture classification, spinal level of injury, neurologic status (American Spinal Injury Association impairment scale), number of levels instrumented, and reason for delay between hospital arrival and surgical treatment. Results The sample included 403 men (73.6%) and 144 women (26.3%), with a mean age of 40.6 years. The main mechanism of trauma was falls (44.4%), followed by car accidents (24.5%). The most frequent pattern of injury was B2 injuries (46.6%), and the most affected level was T12-L1 (42.2%). Neurologic status at admission was 60.5% intact and 22.9% American Spinal Injury Association impairment scale A. The time from admission to surgery was >72 hours in over half the patients and over a week in >25% of them. The most commonly reported reasons for surgical delay were clinical instability (22.9%), lack of operating room availability (22.7%), and lack of hardware for spinal instrumentation (e.g., screws/rods) (18.8%). Conclusions Timing for surgery in this sample of unstable fractures was over 72 hours in more than half of the sample and longer than a week in about a quarter. The main reasons for this delay were clinical instability and lack of economic resources. There is an apparent need for increased funding for the treatment of spinal trauma patients in Latin America.Item Twelve Years of Scientific Production on Medline by Latin American Spine Surgeons(Public Library of Science, 2014) Martins, Delio; Guyot, Juan; Silva, Alvaro; Jiménez, José; Defino, Helton; da Silva, Pedro; Teles, Alisson; Botelho, Ricardo; Falavigna, AsdrubalBackground: Despite the small contribution of LA in the Science Citation Index (SCI), a growing contribution by LA research to international literature has been observed in recent years. Study Design Systematic review. Purpose: To evaluate the scientific contribution of Latin American (LA) Spine Surgeons in the last decade. Methods: A literature search of publications by LA spinal surgeons on topics concerning the spine or spinal cord was performed using an online database; Pubmed.gov. The results were limited to articles published from January 2000 to December 2011. The quality of the publication was evaluated with the journal impact factor (IF), Oxford classification and number of citations. Results: This study comprised 320 articles published in the Medline database by LA spine surgeons from 2000 to 2011. In recent years, there has been an increase in the number of publications by LA spine surgeons. It was observed that 38.4% of LA papers were published in LA journals. 46.6% of the articles were published in journals with an IF lower than 1, and there was no statistically significant difference in the number of articles published in journals with a higher IF during the period. Linear-by-linear association analysis demonstrated an improvement in the level of evidence provided by LA articles published in recent years. Conclusions: This study showed a growth in the number of publications in last 12 years by LA spinal surgeons. It is necessary to discuss a way to increase quantity and quality of scientific publications, mainly through a better education in research.