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Implantation choices, fusion preferences and implant removal after fixation in C1-C2 fractures: An AO Spine Knowledge Forum expert survey
(Springer Science and Business Media LLC, 2026-05-14)
Rishi Mugesh Kanna
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Mitchell Ng
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Andrei F Joaquim
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Gregory D Schroeder
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Mohammad El-Sharkawi
3
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Traumatic Injuries at the Cervicothoracic Junction
(Ovid Technologies (Wolters Kluwer Health), 2025-11-20)
Guillermo Ricciardi
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Guisela Quinteros
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Ignacio Cirillo
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Juan P. Cabrera
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Edgar Marquez García
<jats:sec> <jats:title>Study Design:</jats:title> <jats:p>Multicenter retrospective cohort study.</jats:p> </jats:sec> <jats:sec> <jats:title>Objective:</jats:title> <jats:p>To analyze a multicenter cohort of patients who underwent surgical treatment for C7–T1 traumatic injuries, focusing on their surgical approach and complications.</jats:p> </jats:sec> <jats:sec> <jats:title>Summary of Background Data:</jats:title> <jats:p>C7–T1 injuries are rare and biomechanically complex, with limited evidence guiding optimal surgical management.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>A retrospective analysis of patients with surgically treated C7–T1 traumatic injuries from 13 Latin American Institutions (2014–2023) was conducted. Demographic and clinical data was collected, with a focus on morbidity and complications.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> Among a multicenter database of 545 unstable cervical fractures, 55 (10%) involved the C7–T1 segment. Patients were predominantly male (n=41; 73.2%), with a mean age of 43.2 years (SD). Falls (n=28; 50%) and traffic accidents (n=20; 35.7%) were the leading causes. Neurological deficit was the rule (63.6%). Surgical approaches included single-posterior (44.6%), single-anterior (30.4%), and combined (23.2%). Surgery was performed within 24 hours in 33.9% of cases. Early complications occurred in 17.9%, with pneumonia and surgical site infections being the most common. Complications correlated with longer hospital stays ( <jats:italic toggle="yes">P</jats:italic> =0.029) and associated injuries ( <jats:italic toggle="yes">P</jats:italic> =0.028) but not with surgical delay ( <jats:italic toggle="yes">P</jats:italic> =0.256) or approach ( <jats:italic toggle="yes">P</jats:italic> =0.380). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>C7–T1 injuries are challenging to manage, with posterior approaches most frequently used and anterior-only techniques reserved for fractures without translation. Early complications were common and prolonged hospitalization. Their occurrence appeared to be independent of the surgical approach used.</jats:p> </jats:sec> <jats:sec> <jats:title>Level of evidence:</jats:title> <jats:p>Level III.</jats:p> </jats:sec>
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Occipitocervical dissociation: A narrative review and case series with a novel management algorithm proposal
(Ovid Technologies (Wolters Kluwer Health), 2026-03)
Ignacio Cirillo
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Sebastián Blanco
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Guillermo Ricciardi
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Alfredo Guiroy
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Charles Carazzo
<jats:p>Occipitocervical dissociation refers to dislocation or subluxation of the occipitocervical region. It is a rare injury caused by high-energy trauma that may go unnoticed. It is usually associated with vascular injuries and can lead to catastrophic outcomes. Computed tomography is the imaging modality of choice due to its wide availability and routine use in initial trauma assessment. Magnetic resonance imaging is essential for accurately identifying and characterizing ligamentous injuries. Numerous classifications and measurements are available for diagnosis, and all remain valid today. It requires urgent treatment to prevent additional injury.</jats:p>
1
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Flexion teardrop fracture of the cervical spine: a narrative review
(Bioscientifica, 2025-10-01)
Ignacio Cirillo
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Sebastián Blanco
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Sebastián Cabello
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Guillermo Ricciardi
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Alfredo Guiroy
<jats:p> <jats:list list-type="bullet"> <jats:list-item> <jats:p>Teardrop fractures of the cervical spine are characterized by a triangular-shaped fragment located in the anteroinferior corner of the vertebral body.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Flexion-type teardrop fractures are highly unstable injuries resulting from a flexion-compression mechanism.</jats:p> </jats:list-item> <jats:list-item> <jats:p>A notable feature of these injuries is retrolisthesis of the vertebral body, which is often associated with a high risk of neurological compromise.</jats:p> </jats:list-item> <jats:list-item> <jats:p>The anterior approach is the most commonly used surgical treatment for flexion-type teardrop fractures.</jats:p> </jats:list-item> <jats:list-item> <jats:p>In contrast, extension-type teardrop fractures primarily affect the axis vertebral body and are generally stable injuries that can be treated nonoperatively.</jats:p> </jats:list-item> </jats:list> </jats:p>
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Mechanical Instability After Civilian Thoracolumbar Gunshot Injuries: A Systematic Review to Support Classification Development
(SAGE Publications, 2025-09-11)
Guillermo Alejandro Ricciardi
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Ignacio Cirillo
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Juan Pablo Cabrera
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Otávio Vitório Alvarenga Pereira
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Emiliano Neves Vialle
Study Design Systematic Review.Objectives Identify risk factors for mechanical instability in thoracolumbar gunshot wounds to develop a new classification system.Methods A systematic review following PRISMA 2020 guidelines was conducted across multiple databases from January 1, 1990, to September 12, 2024 (PROSPERO: CRD42023458804).Results Of 2400 records, 33 studies (3195 patients) met inclusion criteria, mostly retrospective and single-center, with varying definitions of instability. Direct comparison was limited due to clinical heterogeneity. Only 12 studies defined mechanical instability, mainly using the Denis three-column theory. Instability was reported in less than 10% of cases, except for one higher-rate outlier. The main markers included vertebral body comminution and potential ligamentous injury. Management was mainly conservative, with a low fixation rate (1.5-9.7%). Imaging relied on CT and static X-rays, with some studies advocating for dynamic radiographs.Conclusion There is a lack of standardized definitions for mechanical instability in civilian thoracolumbar gunshot injuries. Four recurrent unstable patterns were detected, with vertebral body comminution as the most consistent marker. The need for a standardized classification system and further prospective studies is evident.
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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
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Kevin White
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Fernando Padilla Lichtenberger
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Alfredo Guiroy
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Alisson Teles
2
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Time to Surgery for Subaxial Cervical Fractures: A Multicenter Study
(2024)
Guisela Quinteros
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Guillermo Ricciardi
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Ignacio Cirillo
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Edgar Marquez García
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Juan P. Cabrera
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Orthopedic postoperative infection profile and antibiotic sensitivity of 2038 patients across 24 countries – Call for region and institution specific surgical antimicrobial prophylaxis
(2024)
Mengistu G. Mengesha
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Shanmuganathan Rajasekaran
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Karthik Ramachandran
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Vetrivel Chezian Sengodan
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Nor Faissal Yasin
Scopus© Citations 5 2
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Navigating the Indeterminate Zone: Surgeons' Decision-Making Factors in Treating Vertebral Metastases with Spinal Instability Scores of 7–12
(2024)
Federico Landriel
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Kevin White
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Alfredo Guiroy
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Álvaro Silva
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Charles Carazzo
Scopus© Citations 2 5
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Treatment of unilateral cervical facet fractures without evidence of dislocation or subluxation: a narrative review and proposed treatment algorithm
(2024)
Juan Ignacio Cirillo
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Guillermo A Ricciardi
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Facundo Lisandro Alvarez Lemos
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Alfredo Guiroy
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YURAC BARRIENTOS, RATKO JOVAN
<jats:p> <jats:list list-type="bullet"> <jats:list-item> <jats:p>Isolated cervical spine facet fractures are often overlooked.</jats:p> </jats:list-item> <jats:list-item> <jats:p>The primary imaging modality for diagnosing these injuries is a computed tomography scan.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Treatment of unilateral cervical facet fractures without evidence of dislocation or subluxation remains controversial. The available evidence regarding treatment options for these fractures is of low quality.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Risk factors associated with the failure of nonoperative treatment are: comminution of the articular mass or facet joint, acute radiculopathy, high body mass index, listhesis exceeding 2 mm, fragmental diastasis, acute disc injury, and bilateral fractures or fractures that adversely affect 40% of the intact lateral mass height or have an absolute height of 1 cm.</jats:p> </jats:list-item> </jats:list></jats:p>
Scopus© Citations 3 1

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