Browsing by Autor "Juan Ignacio Cirillo"

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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
(SAGE Publishing, 2024) Juan Ignacio Cirillo; Guillermo Alejandro Ricciardi; Juan P. Cabrera; Felipe López-Oliva Muñoz; Lyanne Romero Valverde; Andrei Fernandes Joaquim; Charles Carazzo; Ratko Yurac
Study Designsystematic review.ObjectiveTo evaluate risk factors associated with failure of non-operative management of isolated unilateral facet fractures of the subaxial cervical spine in neurologically intact patients.MethodsA 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).ResultsA 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".ConclusionsLateral 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.
Surgically Managed Symptomatic Intraspinal Lumbar Facet Synovial Cyst Outcome of surgical treatment with resection and instrumented posterolateral fusion, a case series
(Research Square (United States), 2022) Roberto Larrondo Carmona; Juan Ignacio Cirillo; Facundo Álvarez Lemos; José Tomás Muñoz Wilson; A.M. Beaulieu Montoya; Lyonel Beaulieu Lalanne
Abstract BACKGROUND There is controversy regarding the treatment of symptomatic synovial cysts (SSC), specifically, the need for a concomitant fusion when surgical resection of the CS is required. We present a retrospective review of a series of patients treated for SSC of the lumbar region during the last 20 years by a single surgeon, analyzing the current available literature. METHODS Retrospective review. The same surgical technique was applied to all patients. Demographic, clinical, surgical data and synovial cyst recurrence rate were recorded. Postoperative results reported by patients were documented according to the McNab score. RESULTS 69 subjects, with mean follow-up of 7.4 years. 62% (43) were female, with a mean 57.8 years at the time of surgery. In 91.3% (63), the primary management was conservative for a minimum period of 3 months. All subjects underwent surgery due to the failure of conservative treatment. The segment most operated on was L4-L5 (63.77%). 91.3% (63) of the sample reported excellent and good and 6 subjects (8.6%) fair or poor results. There was no evidence of CS recurrence at the operated level. CONCLUSION In SSC, it seems that conservative treatment is only effective in a limited number of patients and in the short term. Thus, the recommendation of a surgical indication should proceed as soon as the conservative management fails to result in significant symptom relief. Based on our results, we recommend, together with the resection of the cyst, the instrumentation of the segment to avoid its recurrence and the management of axial pain.
Surgically Managed Symptomatic Intraspinal Lumbar Facet Synovial Cyst: Outcome of surgical treatment with resection and instrumented posterolateral fusion, a case series.
(Research Square (United States), 2021) Lyonel Beaulieu Lalanne; Facundo Álvarez Lemos; Roberto Larrondo Carmona; Juan Ignacio Cirillo; Andre Beaulieu Montoya; Jose Muñoz Wilson
Abstract PURPOSE : There is controversy regarding the treatment of symptomatic synovial cysts (SSC), specifically, the need for a concomitant fusion when surgical resection of the CS is required. We present a retrospective review of a series of patients treated for SSC of the lumbar region during the last 20 years by a single surgeon, analyzing the current available literature. METHODS : Retrospective review. The same surgical technique was applied to all patients. Demographic, clinical, surgical data and synovial cyst recurrence rate were recorded. Postoperative results reported by patients were documented according to the McNab score. RESULTS : 69 subjects, with mean follow-up of 7.4 years. 62% (43) were female, with a mean 57.8 years at the time of surgery. In 91.3% (63), the primary management was conservative for a minimum period of 3 months. All subjects underwent surgery due to the failure of conservative treatment. The segment most operated on was L4-L5 (63.77%). 91.3% (63) of the sample reported excellent and good and 6 subjects (8.6%) fair or poor results. There was no evidence of CS recurrence at the operated level. CONCLUSION : In SSC, it seems that conservative treatment is only effective in a limited number of patients and in the short term. Thus, the recommendation of a surgical indication should proceed as soon as the conservative management fails to result in significant symptom relief. Based on our results, we recommend, together with the resection of the cyst, the instrumentation of the segment to avoid its recurrence and the management of axial pain.
Transcultural Adaptation and Validation into Spanish of the AO Spine PROST (Patient-Reported Outcome Spine Trauma) Questionnaire
(SAGE Publishing, 2025) Juan Ignacio Cirillo; Pablo Carreño; Guillermo Alejandro Ricciardi; Ratko Yurac; Gonzalo Kido; Víctor Barrientos; Hugo Vilchis Sámano; Eduardo Laos
Study DesignMulticenter, cross-sectional study of cross-cultural adaptation and psychometric validation of a patient-reported outcome measure.ObjectiveTo adapt and validate the Spanish version of the AO Spine Patient-Reported Outcome Spine Trauma (PROST) questionnaire for assessing functional outcomes in patients with traumatic spinal injuries.MethodsThe translation followed Beaton's standardized cross-cultural adaptation process: forward translation, synthesis, back-translation, expert committee review, and final version development. Adult patients (≥18 years) with spinal trauma within the last 13 months were recruited from 4 Level 1 trauma centers across Latin America. Exclusion criteria included polytrauma (ISS >15), complete paralysis (ASIA A-B), and cognitive impairment. Participants completed the Spanish PROST and the SF-36. Concurrent validity was evaluated using Spearman's correlation between PROST and SF-36 domains. Internal consistency was assessed via Cronbach's alpha.ResultsA total of 108 patients were included (mean age 46 ± 15.8 years; 57% male). The Spanish PROST showed excellent internal consistency (α > 0.96). It showed a strong correlation with the SF-36 Physical Functioning domain (rs = 0.83; <i>P</i> < 0.0001) and moderate to strong correlations with Vitality, Mental Health, Bodily Pain, and Social Functioning (rs = 0.54-0.64; <i>P</i> < 0.0001). Moderate correlations were also found with Role Physical and Role Emotional.ConclusionThe Spanish AO Spine PROST is a valid, reliable tool for assessing functional outcomes in spinal trauma patients. These findings support its use in both clinical practice and research settings within Spanish-speaking populations.