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Conventional Radiotherapy Timing and Wound Complication Avoidance After Surgery for Metastatic Spine Disease. A LatAm Modified Delphi Study
(Elsevier BV, 2025-03)
Federico Landriel
;
Kevin White
;
Fernando Padilla Lichtenberger
;
Alfredo Guiroy
;
Alisson Teles
2
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Minimally Invasive Surgery for Traumatic Thoracolumbar Fractures: A Cross-Sectional Study of Spine Surgeons
(2023)
Guillermo A. Ricciardi
;
Juan Ignacio Cirillo Totera
;
Juan P. Cabrera
;
Alfredo Guiroy
;
Charles A. Carazzo
7Scopus© Citations 3
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Low Implant Failure Rate of Percutaneous Fixation for Spinal Metastases: A Multicenter Retrospective Study
(2021)
Alvaro Silva
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YURAC BARRIENTOS, RATKO JOVAN
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Alfredo Guiroy
;
Oscar Bravo
;
Alejandro Morales Ciancio
25Scopus© Citations 3
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Independent Reliability Analysis of a New Classification for Pyogenic Spondylodiscitis
(2020)
Gaston Camino Willhuber
;
Alfredo Guiroy
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ZAMORANO PÉREZ, JUAN JOSÉ
;
Nelson Astur
;
Marcelo Valacco
<jats:sec><jats:title>Study Design:</jats:title><jats:p> Diagnostic study, level of evidence III. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> Pyogenic spondylodiscitis can cause deformity, neurological compromise, disability, and death. Recently, a new classification of spondylodiscitis based on magnetic resonance imaging was published. The objective of this study is to perform an independent reliability analysis of this new classification. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> We selected 35 cases from our database of different spine centers in Latin America and from the literature; 8 observers evaluated the classification and graded the scenarios according to the methodological grading of the classification developed by Pola et al. Cases were sent to the observers in a random sequence after 3 weeks to assess intraobserver reliability. The interobserver and intraobserver reliabilities were performed with Fleiss and Cohen statistics, respectively. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> The overall Fleiss κ value for interobserver agreement was substantial, with 0.67 (95% CI = 0.43-0.91) in the first reading and 0.67 (95% CI = 0.45-0.89) in second reading for the main types of classification. The Cohen κ value for intraobserver agreement was also substantial, with 0.68 (95% CI = 0.45-0.92). The interobserver agreement analysis for the subtypes of this classification was overall substantial, with 0.60 (95% CI = 0.37-0.83) in the first reading and 0.61 (95% CI = 0.41-0.81) in the second reading. The overall intraobserver agreement for subtypes of the classification was also substantial, with 0.63 (95% CI = 0.34-0.93). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> The new classification developed by Pola et al showed substantial interobserver and intraobserver agreements. More studies are required to validate the usefulness of this classification especially in clinical practice. </jats:p></jats:sec>
Scopus© Citations 14 7
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Accuracy and reliability of the AO Spine subaxial cervical spine classification system grading subaxial cervical facet injury morphology
(2021)
Juan P. Cabrera
;
Ratko Yurac
;
Alfredo Guiroy
;
Andrei F. Joaquim
;
Charles A. Carazzo
13Scopus© Citations 7
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Unplanned Readmission Following Early Postoperative Complications After Fusion Surgery in Adult Spine Deformity: A Multicentric Study
(2021)
Gaston Camino-Willhuber
;
Alfredo Guiroy
;
Mariano Servidio
;
Nelson Astur
;
Fernando Nin-Vilaró
<jats:sec><jats:title>Study Design:</jats:title><jats:p> Multicentric retrospective study, Level of evidence III. </jats:p></jats:sec><jats:sec><jats:title>Objective:</jats:title><jats:p> The objective of this multicentric study was to analyze the prevalence and risk factors of early postoperative complications in adult spinal deformity patients treated with fusion. Additionally, we studied the impact of complications on unplanned readmission and hospital length of stay. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> Eight spine centers from 6 countries in Latin America were involved in this study. Patients with adult spinal deformity treated with fusion surgery from 2017 to 2019 were included. Baseline and surgical characteristics such as age, sex, comorbidities, smoking, number of levels fused, number of surgical approaches were analyzed. Postoperative complications at 30 days were recorded according to Clavien-Dindo and Glassman classifications. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> 172 patients (120 females/52 males, mean age 59.4 ± 17.6) were included in our study. 78 patients suffered complications (45%) at 30 days, 43% of these complications were considered major. Unplanned readmission was observed in 35 patients (20,3%). Risk factors for complications were: Smoking, previous comorbidities, number of levels fused, two or more surgical approaches and excessive bleeding. Hospital length of stay in patients without and with complications was of 7.8 ± 13.7 and 17 ± 31.1 days, respectively ( P 0.0001). </jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p> The prevalence of early postoperative complications in adult spinal deformity patients treated with fusion was of 45% in our study with 20% of unplanned readmissions at 30 days. Presence of complications significantly increased hospital length of stay. </jats:p></jats:sec>
2Scopus© Citations 16
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CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?
(2021)
Juan P. Cabrera
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YURAC BARRIENTOS, RATKO JOVAN
;
Andrei F. Joaquim
;
Alfredo Guiroy
;
Charles A. Carazzo
<jats:sec><jats:title>Study Design:</jats:title><jats:p> Cross-sectional survey. </jats:p></jats:sec><jats:sec><jats:title>Objectives:</jats:title><jats:p> Assessment of subaxial cervical facet injuries using the AO Spine Subaxial Cervical Spine Injury Classification System is based on CT scan findings. However, additional radiological evaluations are not directly considered. The aim of this study is to determine situations in which spine surgeons request additional radiological exams after a facet fracture. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> A survey was sent to AO Spine members from Latin America. The evaluation considered demographic variables, routine use of the Classification, as well as the timepoint at which surgeons requested a cervical MRI, a vascular study, and/ or dynamic radiographs before treatment of facet fractures. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> There was 229 participants, mean age 42.9 ± 10.2 years; 93.4% were men. Orthopedic surgeons 57.6% with 10.7 ± 8.7 years of experience in spine surgery. A total of 86% used the Classification in daily practice. An additional study (MRI/vascular study/and dynamic radiographs) was requested in 53.3%/9.6%/43.7% in F1 facet injuries; 76.0%/20.1%/50.2% in F2; 89.1%/65.1%/28.4% in F3; and 94.8%/66.4%/16.6% in F4. An additional study was frequently required: F1 72.5%, F2 86.9%, F3 94.7%, and F4 96.1%. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> Spine surgeons generally requested additional radiological evaluations in facet injuries, and MRI was the most common. Dynamic radiographs had a higher prevalence for F1/F2 fractures; vascular studies were more common for F3/F4 especially among surgeons with fewer years of experience. Private hospitals had a lower spine trauma cases/year and requested more MRI and more dynamic radiographs in F1/F2. Neurosurgeons had more vascular studies and dynamic radiographs than orthopedic surgeons in all facet fractures. </jats:p></jats:sec>
6Scopus© Citations 4
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An independent inter- and intra-observer agreement assessment of the AOSpine upper cervical injury classification system
(2022)
Julio Urrutia
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Byron Delgado
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Gaston Camino-Willhuber
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Alfredo Guiroy
;
Nelson Astur
4 1Scopus© Citations 3
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Risk Factors for Postoperative Complications After Surgical Treatment of Type B and C Injuries of the Thoracolumbar Spine
(2022)
Juan P. Cabrera
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Charles A. Carazzo
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Alfredo Guiroy
;
Kevin P. White
;
Joana Guasque
9Scopus© Citations 4
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Reliability Evaluation of the New AO Spine-DGOU Classification for Osteoporotic Thoracolumbar Fractures
(2022)
Guisela Quinteros
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Juan P. Cabrera
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Julio Urrutia
;
Charles A. Carazzo
;
Alfredo Guiroy
Scopus© Citations 13 1

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