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Controversies in management of floating lateral mass fractures of subaxial cervical spine: a narrative review
(Elsevier BV, 2026-02)
YURAC BARRIENTOS, RATKO JOVAN
;
Andrei Joaquim
;
Sebastian Bigdon
;
Mohamed M. Aly
;
Ignacio Cirillo
1
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Does the treatment of cervicothoracic junction fractures differ from subaxial cervical fractures? A narrative review
(Elsevier BV, 2026-02)
YURAC BARRIENTOS, RATKO JOVAN
;
Gaurav Raj Dhakal
;
Andrei Joaquim
;
Guillermo Ricciardi
;
Cezar Popescu
1
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Flexion teardrop fracture of the cervical spine: a narrative review
(Bioscientifica, 2025-10-01)
Ignacio Cirillo
;
Sebastián Blanco
;
Sebastián Cabello
;
Guillermo Ricciardi
;
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>
1
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Risk Factors for Failure of Non-operative Management in Isolated Unilateral Non-displaced Facet Fractures of the Subaxial Cervical Spine: Systematic Review and Meta-Analysis
(2024)
Ignacio Cirillo
;
Guillermo Alejandro Ricciardi
;
Juan Pablo Cabrera
;
Felipe Lopez Muñoz
;
Lyanne Romero Valverde
<jats:sec><jats:title>Study Design</jats:title><jats:p> systematic review. </jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p> To evaluate risk factors associated with failure of non-operative management of isolated unilateral facet fractures of the subaxial cervical spine in neurologically intact patients. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A systematic review of the PubMed, Embase, LILACS, and Cochrane Library databases was conducted in order to determine risk factors associated with failure of non-operative management in isolated unilateral facet fractures of the subaxial cervical spine without facet and/or vertebral displacement, in neurologically intact patients. Our research was in line with the PRISMA Statement and registered on PROSPERO (CRD42023405699). </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> A total of 1639 studies were identified through a database search on May 5, 2023. In total, 7 studies from the databases were included, along with 1 study found through a manual citation search. The evidence showed high clinical heterogeneity, a serious risk of bias according to the ROBINS-I tool, and a predominance of retrospective cohort studies. In comparison to less complex facet fractures, lateral floating mass fractures were found to have 5.41 times higher odds of failure of non-operative management (OR = 5.41; 95% CI = 1.32, 22.19). We calculated the potential association between lower absolute fracture height and non-operative treatment success [Fracture height (percentage) Mean Difference = −17.51 (−28.22, −6.79 95% CI); Absolute height Mean Difference: −0.46 (−0.60, −0.31 95% CI)]. Other risk factors were not included in the meta-analysis due to lack of data. The level of certainty was rated as “very low”. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> Lateral floating mass cervical facet fractures and larger fracture fragment size (measured either in absolute terms or as a percentage) are significant risk factors for failure of non-operative treatment. </jats:p></jats:sec>
Scopus© Citations 6
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AO Spine-DGOU Osteoporotic Fracture Classification System: Internal Validation by the AO Spine Knowledge Forum Trauma
(2024)
Julian Scherer
;
Andrei Joaquim
;
Alex Vaccaro
;
Rishi Kanna
;
Mohammad El-Sharkawi
<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> Injury classifications are important tools to identify fracture patterns, guide treatment-decisions and aid to identify optimal treatment plans. The AO Spine-DGOU Osteoporotic Fracture (OF) classification system was developed, and the aim of this study was to assess the reliability of this new classification system. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> 23 Members of the AO Spine Knowledge Forum Trauma participated in the validation process. Participants were asked to rate 33 cases according to the OF classification at 2 time points, 4 weeks apart (assessment 1 and 2). The kappa statistic (κ) was calculated to assess inter-observer reliability and intra-rater reproducibility. The gold master key for each case was determined by approval of at least 5 out of 7 members of the DGOU. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> A total of 1386 ratings (21 raters) were performed. The overall inter-rater agreement was moderate with a combined kappa statistic for the OF classification of 0.496 in assessment 1 and 0.482 in assessment 2. The combined percentage of correct ratings (compared to gold-standard) in assessment 1 was 71.4% and 67.4% in assessment 2. The average intra-rater reproducibility was substantial (κ = 0.74, median 0.76, range 0.55 to 1.00, SD 0.13) for the assessed fracture types. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> The assessed overall inter-rater reliability was moderate and substantial in some instances. The average intra-rater reproducibility is substantial. It seems that appropriate training of the classification system can enhance inter- and intra-rater reliability. </jats:p></jats:sec>
Scopus© Citations 4 1
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Reliability Evaluation of the New AO Spine-DGOU Classification for Osteoporotic Thoracolumbar Fractures
(2022)
Guisela Quinteros
;
Juan P. Cabrera
;
Julio Urrutia
;
Charles A. Carazzo
;
Alfredo Guiroy
Scopus© Citations 13 1

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