Research Projects

Research Projects and Published Articles

Management of Unilateral Cervical Facet Joint Dislocation in Neurologically Intact Patients: Results of an Ao Spine latin American Survey
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigator
Andrei Joaquim
Team
Alisson Teles
Asdrubal Falavigna
Charles Carazzo
Ericson Sfreddo
Juan P. Cabrera
Marcelo Valacco
Orlando Neto
Description
The treatment of unilateral CFD in patients without neurologic deficits remains controversial, especially in the choice of the best surgical approach. The objective of the study is to determine the way spine surgeons from Latin America manage this condition.
Journal
World Neurosurgery
Neurosurgery versus orthopedic surgery: Who has better access to minimally invasive spinal technology?
Study Group
MISS
Coordinator
Asdrubal Falavigna
Principal investigator
Alfredo Guiroy
Team
Alberto Gotfryd
Charles Carazzo
Juan P. Cabrera
Martin Gagliardi
Matias Pereira
Nicolás Coombes
Néstor Taboada
Description
To evaluate differences in neurosurgeons versus orthopedists access to technologies needed to perform minimally invasive spine surgeries (MISS) in Latin America.
Journal
Surgical Neurology International
Access to Technology and Education for the Development of Minimally Invasive Spine Surgery Techniques in Latin America
Study Group
MISS
Coordinator
Asdrubal Falavigna
Principal investigator
Alfredo Guiroy
Team
André Arruda
Juan P. Cabrera
Martin Gagliardi
Nicolás Coombes
Néstor Taboada
Description
To evaluate access to the technologies and education needed to perform minimally invasive spine surgery (MISS) in Latin America.
Journal
World Neurosurgery
Teaching Training and Surgical Education in Minimally Invasive Surgery (MIS) of the Spine: What Are the Best Teaching and Learning Strategies for MIS? Do We Have Any Experience and Data?
Study Group
MISS
Coordinator
Néstor Taboada
Principal investigator
Asdrubal Falavigna
Team
Alfredo Guiroy
Description
Advances in new technologies give the surgeons confidence to manage complex spine conditions with a lower morbidity rate. This has changed the expectations of patients and medical payers and foreshadows the shift now underway: the use of minimally invasive techniques. The ethical considerations of learning directly on patients require a change in the education and training programs.
Journal
Global Spine Journal
Multilanguage health record database focused on the active follow-up of patients and adaptable for patient-reported outcomes and clinical research design
Coordinator
Asdrubal Falavigna
Principal investigator
Leonardo Pellizzoni
Team
Leonardo Pellizzoni
Description
To present electronic health record database for monitoring clinical or surgical interventions and assess the usability.
Journal
International Journal of Medical Informatics
Perception of complications by spine surgeons
Coordinator
Giovanni Barbanti Brodano
Principal investigator
Asdrubal Falavigna
Team

Alfredo Guiroy
Jefferson Dedea

Description
The perception of major versus minor complications may vary according to surgeons, institutions, and different specialties. Here, we analyzed the geographic distribution of the different types/severities of the most frequent complications in spinal surgery, and assessed how the perception of spine surgeons about postoperative complications differed.
Journal
Surgical Neurology International
Independent Reliability Analysis of a New Classification for Pyogenic Spondylodiscitis
Coordinator
Marcelo Valacco
Principal investigator
Gastón Camino-Willhuber
Team
Alfredo Guiroy
Juan Zamorano
Nelson Astur
Description
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.
Journal
Global Spine Journal
Barriers of neurophysiology monitoring in spine surgery: Latin America experience
Coordinator
Asdrubal Falavigna
Principal investigator
Alfredo Guiroy
Team

Gastón Camino-Willhuber
Juan Cabrera
Juan Emmerich
Marcelo Valacco
Martin Gagliardi

Description
Intraoperative neurophysiological monitoring (IOM) has become valuable in spine surgery. Unfortunately, it is not always available in many spine centers, especially in developing countries. Our aim was to evaluate the accessibility and barriers to IOM in spine surgery in Latin America.
Journal
Surgical Neurology International
Letter to the Editor: Is COVID-19 the Cause of Delayed Surgical Treatment of Spine Trauma in Latin America?
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigator
Juan P.Cabrera
Team
Alfredo Guiroy
Andrei F. Joaquim
Charles Carazzo
Juan Zamorano
Marcelo Valacco
Journal
World Neurosurgery
COVID-19 Impact Among Spine Surgeons in Latin America
Coordinator
Marcelo Valacco
Principal investigator
Alfredo Guiroy
Team
Carlos Zanardi
Federico Landriel
Gastón Camino-Willhuber
Juan P. Guyot
Martín Gagliardi
Nicolas Coombes
Description
The aim of this study was to evaluate the impact of the COVID-19 outbreak in spine surgeons in Latin America.
Journal
Global Spine Journal
Impacto psicosocial de la pandemia por COVID-19 en cirujanos de columna argentinos
Coordinator
Marcelo Valacco
Principal investigator
Alfredo Guiroy
Team
Carlos Zanardi
Federico Landriel
Gastón Camino-Willhuber
Juan P. Guyot
Martín Gagliardi
Nicolas Coombes
Description
Evaluar el impacto psicosocial de la pandemia por COVID-19 en los cirujanos de columna de Argentina.
Journal
Revista Argentina Neurocirugía
Genotoxicity Clues to Predict Intervertebral Disc Degeneration: A Systematic Review
Coordinator
Asdrubal Falavigna
Principal investigator
Charles Carazzo
Team

Bruno Saciloto
Manuela Figueiró
Natalia Nicoletti

Description
IDD is the main disorder causing low back pain and is the most promising target for intervention. Many factors can contribute to the etiology, such as genetics, environment and lifestyle, but it is not yet fully understood. DNA damage can influence this process and needs to be studied, as well as the agents that can determine these damages.
Journal
Scientific Research
Surgical delay in thoracolumbar fractures in Latin America. How long it takes?
Accepted
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigators
Alfredo Guiroy
Charles Carazzo
Team
Juan P. Cabrera
Juan Zamorano
Description
To identify delays to surgery stabilizing AO-Spine types B and C thoracolumbar fractures and the main reasons for such delays across Latin America.
Journal
World Neurosurgery
Minimally invasive approach for the treatment of intradural extramedullary spinal tumors Technical note
Accepted
Study Group
Tumor
Coordinators
Federico Landriel
Santiago Hem
Principal investigators
Federico Landriel
Santiago Hem
Description
To describe the technique of minimally invasive approach for the treatment of intradural extramedullary tumors in the different spinal segments.
Journal
SNI
30-day readmission rate, hospital length of stay and complications in Adult Spinal deformity after fusion surgery
Accepted
Study Group
Degenerative/Deformity
Coordinator
Marcelo Valacco
Principal investigator
Gastón Camino-Willhuber
Team
Alfredo Guiroy
Allan Ono
Barón Zárate
Bruno Saciloto
Emiliano Vialle
Fernando Alvarado
Fernando Nin
Marcelo Valacco
Mariano Servidio
Murilo Daher
Nelson Astur
Olavo Letaif
Ratko Yurac
Objective
To analyze 30-days unplanned readmission rates, hospital length of stay, postoperative clinical and surgical complications, and risk factors in adult spinal deformity patients operated with fusion surgery. Secondary objectives are to compare readmission and complications in patients with 1 or 2 levels with 3 or more fusion level surgeries.
An independent inter- and intra-observer agreement assessment of the Eno classification of sacroiliac joint degeneration.
Sent to publication
Study Group
Degenerative/Deformity
Coordinator
Marcelo Valacco
Principal investigator
Gastón Camino-Willhuber
Team
Julio Urrutia
Matias Borensztein
Nelson Astur
Osvaldo Velan
Pablo Cikutovich
Objective
To validate a classification of sacroiliac joint degeneration through intra and interobserver analysis. As a secondary objective, a comparison will be made between the intra and interobserver agreement among spine surgeons and medical imaging specialists.
Hardware failure after percutaneous fixation of spine metastasis
Sent to publication
Study Group
Tumor
Coordinator
Ratko Yurac
Principal investigator
Alvaro Silva
Team
Alfredo Guiroy
Oscar Bravo
Santiago Hem
Objective
To evaluate the incidence and types of implant failure in patients with spinal metastases operated with minimally invasive stabilization surgeries without fusion.
Diagnosis and treatment of subaxial facet cervical fracture: variability according to AO Spine classification system
Sent to publication
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigator
Juan P. Cabrera
Team
Alfredo Guiroy
Andrei Joaquim
Juan P. Cabrera
Juan Zamorano
Objective
To assess the diagnostic accuracy and reliability of this new system’s facet injury morphological classifications.
Minimally invasive versus open surgery for the treatment of type B and C thoracolumbar injuries: A PRISMA Systematic Review
Sent to publication
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigator
Charles Carazzo
Team
Alfredo Guiroy
Andrei Joaquim
Juan P. Cabrera
Juan Zamorano
Objective
To compare the outcomes of conventional open surgery versus minimally invasive spine surgery (MISS) for the treatment of AOSpine type B and C thoracolumbar injuries.
Management of Lumbar Disc Herniation with Radiculopathy: Results of an Iberian-Latin American Survey
Sent to publication
Coordinator
Ratko Yurac
Principal investigator
Guisela Quinteros
Team
Bartolomé Marre Pacheco
Edson Pudles
Juan Zamorano
Máximo-Alberto Díez-Ulloa
Objective
To assess how Iberian and Latin American spine surgeons treat lumbar disc herniation (LDH) in patients with radiculopathy.
20 tips to avoid and handle problems in the placement of percutaneous pedicle screws
Sent to publication
Study Group
MISS
Coordinator
Alfredo Guiroy
Principal investigator
Federico Landriel
Team
Alejandro Morales
Cristiano Menezes
Nestor Taboada
Santiago Hem
Sebastian Kornefeld
Objective
To provide a series of recommendations to solve specific problems and prevent complications during the learning curve of this technique, resulting from the experience of several spinal surgeons at different minimally invasive surgery reference centers.
Simultaneous internal and external validations of a classification of Spondylodiscitis. A multicentric study (Part 1)
Ongoing
Study Group
Degenerative/Deformity
Coordinators
Marcelo Valacco
Giovanni Barbanti Brodano
Principal investigators
Gastón Camino-Willhuber
Enrico Pola
Team
Alfredo Guiroy
Nelson Astur
Objective
To perform a validation analysis. A concomitant analysis will be conducted among the original authors of the classification and an external independent group to assess the internal and external interobserver and intraobserver agreements.
Usefulness of the modified Brighton score to predict the need of surgical treatment. A multicentric evaluation (Part 2)
Ongoing
Study Group
Degenerative/Deformity
Coordinators
Marcelo Valacco
Giovanni Barbanti Brodano
Principal investigators
Gastón Camino-Willhuber
Enrico Pola
Julio Urrutia
Team
Alfredo Guiroy
Nelson Astur
Objective
To evaluate the concordance of the modified BSDS to assess its usefulness to predict need for surgical treatment.
Surgical delay in adolescent idiopathic scoliosis in Latin America. How long it takes?*
Ongoing
Study Group
Degenerative/Deformity
Coordinator
Emiliano Vialle
Principal investigator
Alfredo Guiroy
Team
Allan Ono
Objective
To analyze the timing for surgery in patients with AIS in Latin America
Spinal injection Survey among spine surgeons in Latin America
Ongoing
Study Group
Degenerative/Deformity
Coordinator
Ratko Yurac
Principal investigator
Marcelo Molina
Team
Alberto Marti
Dennys Gonzalez
Marcelo Valacco
Ramón Torres
Samuel Pantoja
Objective
To evaluate the indications and techniques of spinal injection (SI) in patients with degenerative lumbar stenosis (DLS) in Latin America.
Frailty. Latin America Perspectives
Ongoing
Study Group
MISS
Coordinator
Alfredo Guiroy
Principal investigator
Matías Pereira
Team
Gastón Camino-Willhuber
Objective
To assess the usage of fragility indexes or substitutes among Latin American Spine surgeons and the main advantages or barriers considering their implementation.
Unraveling the intermediate SINS. Criteria for surgical decision making. A multicentric evaluation
Ongoing
Study Group
Tumor
Coordinators
Federico Landriel
Santiago Hem
Principal investigators
Federico Landriel
Santiago Hem
Team
Alfredo Guiroy
Alvaro Silva
Christiano Simões
Gustavo Guiraldo
Marcelo Valacco
William Teixeira
Objective
To determine which variables lead to choosing a conservative or surgical behavior and if the absolute number of SINS correlates with a surgical indication.
External Validation of a classification system for osteoporotic thoracolumbar fractures (OF- classification)
Ongoing
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigator
Guisela Quinteros
Team
Alfredo Guiroy
Charles Carazzo
Juan P. Cabrera
Objective
To perform a multicenter interobserver and intraobserver agreement evaluation of the OF Classification.
Traumatic Cervical Spine Injuries in Rugby Players: A Combined Case Series from 3 Latin American Countries
Ongoing
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigator
Juan Zamorano
Team
Alfredo Guiroy
Juan P. Cabrera
Objective
To describe a case series of rugby players from 3 Latin American countries with traumatic cervical spine injuries due to game-related accidents, focusing on injury mechanism, treatment modality, and return to play.
Vertebral Augmentation versus Hybrid Stabilization in the Surgical Treatment of Osteoporotic Thoracolumbar Vertebral Fractures: A Systematic Review and Meta-Analysis
Ongoing
Study Group
Trauma
Coordinator
Ratko Yurac
Principal investigator
Juan P. Cabrera
Team
Andrei Joaquim
Alfredo Guiroy
Charles Carazzo
Guisela Quinteros
Juan Zamorano
Objective
To investigate the clinical outcome of the osteoporotic vertebral fractures of the thoracolumbar spine with vertebral augmentation or hybrid stabilization.
Tubercolosis
Ongoing
Coordinator
Marcelo Valacco
Principal investigator
Marcelo Valacco
Objective
To describe the clinical and radiological results of patients operated on for spinal tuberculosis deformity in Latin America with a follow-up of more than 12 months.
Guidelines
Ongoing
Coordinator
Asdrubal Falavigna
Principal investigator
Asdrubal Falavigna
Team
Alfredo Guiroy
Alisson R. Teles
Objective
To discuss the Clinical Practice Guidelines for the management of spinal disorders.
Outcomes for single position circumferential fusion vs lateral then prone position, a PRISMA systematic review
Ongoing
Coordinator
Alfredo Guiroy
Principal investigator
Alfredo Guiroy
Team
Andrei Joaquim
Charles Carazzo
Gastón Camino-Willhuber
Juan P. Cabrera
Martín Gagliardi
Objective
To evaluate the outcomes between single positions spinal fusion versus lateral then prone position fusion.
The role of Modified frailty Index in prediction of 30 and 90 days-postoperative complications in spine surgery. A multi centric prospective registry in Latin America.
Ongoing
Study Group
Degenerative/Deformity
Coordinator
Gastón Camino-Willhuber
Principal investigator
Celeste Zamora
Objective
To analyze the modified frailty index (mFI) to predict complications in 30 and 90 days-postoperative and unplanned readmissions through a multicenter prospective registry of patients treated surgically for a spinal condition.
Crosstalk between autophagy and apoptosis in intervertebral disc disease
Ongoing
Coordinator
Asdrubal Falavigna
Principal investigator
Bruno Saciloto
Team
Charles Carazzo
Manuela Figueiró
Natália Nicoletti
Asdrubal Falavigna
Objective
To clarify the crosstalk between autophagy and apoptosis and the possible signaling pathways involved in degenerative disc disease (DDD).
Solution blow spinning (SBS) as new feasible carrier to treat traumatic spinal cord injury
Ongoing
Coordinator
Asdrubal Falavigna
Principal investigator
André Arruda
Team
Fernanda Dias
Natália Nicoletti
Otavio Bianchi
Objective
To develop a simple, translational and cost-effective system that combines active biomaterials and cellular therapy (stem cells) in a new delivery system, feasible for future translational application.
Acute spinal cord injury
Ongoing
Coordinator
Asdrubal Falavigna
Principal investigator
Asdrubal Falavigna
Team
Alisson R. Teles
Objective
To evaluate the opinion and practices among spine surgeons on timing of decompression in patients with acute traumatic spinal cord injury.
The use of Artificial Intelligence to predict improvement after hernial disc surgery
Ongoing
Coordinator
Asdrubal Falavigna
Principal investigator
Daniel Cunha
Team
Leandro Corso
Objective
To identify the questions in quality of life questionnaires that had the most significant correlation with patient satisfaction.
Perceived impact of gender on spine surgery
Ongoing
Coordinator
Asdrubal Falavigna
Principal investigator
Asdrubal Falavigna
Objective
To identify gender-based differences within spine surgery, trying to identify factors that may influence male and female careers.