Alisson R. Teles

Hospital São José - Santa Casa de Porto Alegre

BACKGROUND CONTEXT: Although 40% of adolescent idiopathic scoliosis (AIS) patients present with chronic back pain, the pathophysiology and underlying pain mechanisms remain poorly understood. We hypothesized that development of chronic pain syndrome in AIS is associated with alterations in pain modulatory mechanisms. PURPOSE: To identify the presen...

OBJECTIVE The aim of this study was to evaluate the anatomical and surgical risk factors for screw-related facet joint violation at the superior level in lumbar fusion. METHODS The authors conducted a retrospective review of a consecutive series of posterior lumbar instrumented fusions performed by a single surgeon. Inclusion criteria were primary...

Study design: Systematic review. Objective: There is a need for synthesizing data on effectiveness of treatments for patients with adult spinal deformity (ASD) due to its increasing prevalence and health care costs for these patients. The objective of this review was to estimate the effectiveness of surgery versus nonoperative care in patients w...

Study design: Cross-sectional. Objectives: To evaluate current practice of Latin American spine surgeons regarding surgical timing in patients with traumatic spinal cord injury (tSCI) and to identify potential barriers for early surgery. Setting: Web-based. Methods: A web-based questionnaire was sent to members of AOSpine Latin America. Ques...

Study design: Cohort study. Objetive: Our goal was to verify the validity of the GAP score, SRS-Schwab, and Roussouly's theoretical apex of lordosis in predicting mechanical complications in ASD. Summary of background data: Achieving adequate sagittal alignment is critical to obtain favorable outcomes in adult spinal deformity (ASD) surgery. I...

Lumbar disc herniation (LDH) is a relatively common pathology usually presenting with unilateral radiculopathy ipsilateral to the disc herniation. Some patients can present with contralateral radicular symptoms. The objective of this article is to review the current literature on lumbar disc herniations with contralateral radiculopathy regarding it...

Study design: Cross-sectional survey study. Objective: To evaluate the prevalence of burnout, assess the personal and professional characteristics associated with burnout in spine surgeons and determine their quality of life. Summary of background data: Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and decreas...

Introduction The treatment of unilateral CFD in patients without neurological deficits remains controversial, especially in the choice of the best surgical approach. Our objective is to determine the way spine surgeons from Latin America manage this condition. Methods A survey regarding management and surgical strategies was conducted by AO Spine...

Facet joint osteoarthritis is prevalent in young patients with adolescent idiopathic scoliosis (AIS) and might contribute to back pain. Toll‐like receptors (TLR) have been linked to cartilaginous tissue degeneration but their involvement in facet joint osteoarthritis in AIS patients is still unknown. We compared baseline gene expression levels of T...

PurposeTo define the relationship between 3D radiological features, psychological factors, and back pain prevalence and intensity in patients with adolescent idiopathic scoliosis (AIS).Methods Consecutive AIS patients answered self-reported questionnaires and underwent simultaneous posterior–anterior and lateral scans of the spine (EOS Imaging, Par...

OBJECTIVE The objective of this study was to determine the publication rate of abstracts presented at the annual meetings of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves (Spine Summit). METHODS The authors used a search algorithm in PubMed to determine the publication rate of abstracts presented at the Spine Summit from 200...

Abstract Background Adolescent idiopathic scoliosis (AIS) has been associated with diminished postural stability and a greater prevalence of back pain. Currently, the literature is lacking information on the effect of spinal fusion on both postural stability and its association with back pain. Our objectives were to evaluate the postsurgical effect...

Background context Zero-profile (also called self-lock- ing, anchored or stand-alone cages) have been recently proposed as an interesting alternative for anterior cervical discectomy and fusion (ACDF), as they are supposed to reduce the rates of post-operative cage extrusion without necessarily incurring in the additional surgical time and increase...

Degenerative lumbar spine disease (DLSD) is a heterogenous group of conditions that can significantly affect patients’ quality of life. Lateral lumbar interbody fusion (LLIF) is one of the treatment modalities for DLSD that has been increasing in popularity over the past decade. The treatment of DLSD should be individualized based on patients’ symp...

Early-onset scoliosis (EOS) correction techniques have evolved slowly over the past 40 years and still remain a challenge for the spine surgeon. Avoiding spinal fusion in these patients is key to decreasing morbidity and mortality in this population. Current treatments for EOS include both conservative and surgical options. The authors present the...

Background The medical literature suggests that facet dislocations (FDs) must be managed surgically, even in the absence of spinal cord injury. In fact, there is no standard guideline for managing FD cases and whether magnetic resonance imaging (MRI) should be utilized for optimizing treatment planning. Methods Fifteen cases of FD were evaluated t...

Around 6% of the elderly population over 65 years of age are affected by adult spinal deformity (ASD). The increasing prevalence of ASD with aging has prompted discussion regarding the use of various techniques for its treatment, such as surgery and conservative treatment. The objective of this study is to investigate whether surgical treatment dem...

Introduction: Publication rate can indirectly assess the quality of research presented in scientific meetings. Considering presentations at orthopedic surgery and neurosurgery meetings, 10.5-66% of abstracts are published in scientific journals. Publication rate of abstracts presented at CSS Meetings is unknown. The objective of this study was to...

Background: The days following surgery are a critical period where the use of opioids predicts long-term outcomes in adults. It is currently unknown as to whether opioid consumption throughout the acute postoperative period is associated with long-term outcomes in pediatric patients. The aims of this study were to characterize opioid consumption tr...

INTRODUCTION: Surgical skill training is difficult due to limited resources and the associated risks in the clinical set- ting. There have been many studies that have looked at optimizing resident skill techniques out of the operating room to optimize intraoperative teaching. Specifically, as seen in spine surgery performing a laminectomy with a hi...

Background: Spine surgeries performed via the posterior approach have a higher infection rate. Several theories have been proposed, including poor hygienic condition of bed sheets and traumatized muscle associated with supine position promoting circulatory impairment. We investigated the influence of supine position on the rate of deep wound infec...

Patient-controlled analgesia (PCA) is common practice for acute postoperative pain management. Postoperative PCA use decreases pain intensity and improves patient satisfaction when compared to non-PCA routes of medication administration. Although PCA has several advantages regarding efficacy and safety, adverse events remain a concern. Programming...

BACKGROUND: Necrotizing fasciitis (NF) is a surgical diagnosis characterized by a rapidly progressive soft tissue infection, widespread tissue necrosis, and associated systemic illness. Friability of the superficial fascia, dishwater-gray exudate, and absence of pus are surgical characteristics of this diagnosis. Due to the rapid progression of the...

Despite the burden of chronic subdural hematomas (CSDH) in neurosurgical services, the gold standard management of this condition still remains controversial. In 2012, we conducted a survey with the heads of neurosurgical services bound to the Brazilian Society of Neurosurgery (Sociedade Brasileira de Neurocirurgia) regarding the treatment strategi...

Background Monoaminergic pathways are involved in the process of pain inhibition and facilitation. The objective of this study was to investigate the role of blood monoamines as biomarkers of conditioned pain modulation (CPM) efficacy. Methods One hundred and five pediatric patients with chronic back pain were enrolled in this observational study....

Objective: A common belief among many practicing spine surgeons is that instrumentation can be removed during revision surgery in cases of successful posterolateral or anterior spinal fusions, confirmed by computed tomography (CT) and intraoperative exploration. The stress- shielding effect of spinal instrumentation was well-described in the late 8...

Study Design Cross-sectional study. Objectives To continue the line of a previous publication using steroid for acute spinal cord injury (SCI) by spine surgeons from Latin America (LA) and assess the current status of methylprednisolone (MP) prescription in Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) to determine targe...

Chondrosarcomas and chordomas are the most common malignant primary bone tumors involving the spine. Surgery is usually the initial treatment of these tumors. In the past two decades, surgery for spine tumors has evolved from palliative procedures to en bloc resections of tumors. In this chapter, the authors discuss the rationale for the surgical t...

Stand-alone cervical laminectomy for degenerative cervical myelopathy (DCM) has become increasingly rare due to risk of postlaminectomy kyphosis. This article discusses the biomechanics of cervical degeneration and how laminectomy effects spine stability, and summarizes relevant clinical studies to help guide surgical decision-making for the poster...

OBJECTIVE The aim of this study was to evaluate the anatomical and surgical risk factors for screw-related facet joint violation at the superior level in lumbar fusion. METHODS The authors conducted a retrospective review of a consecutive series of posterior lumbar instrumented fusions performed by a single surgeon. Inclusion criteria were primary...

OBJECTIVE The cost of spine management is rising. As diagnostic imaging accounts for approximately 10% of total patient care spending, there is interest in determining if economies could be made with regard to the routine consultation of radiology for image interpretation. In the context of spine trauma, both the spine surgeon and the radiologist i...

Objectives: Patient-reported outcome measures PROMs are the most widely accepted means of measuring outcomes following spine procedures. We sought to determine the current status of worldwide use of PROMs in Latin America (LA), Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) in order to determine the barrier to its full im...

Perioperative Management in Robotic Surgery covers perioperative considerations for robot-assisted surgery (RAS), from preoperative through to postoperative. This is the first extensive, evidence-based, clinical work covering the perioperative management of commonly performed and emerging RAS. Included inside are discussions of surgical procedures,...

Study Design: The authors performed a retrospective controlled study of patients diagnosed with lumbar degenerative disc disease who received surgical intervention (either total disc replacement [TDR]/Activ-L or anterior lumbar interbody fusion [ALIF]) at a single tertiary-care hospital from 2007-2010. Objectives: To investigate the clinical outcom...

Ossification of the ligamentum flavum (OLF) is a rare condition in which the ligamentum flavum, due to mechanical, biological and genetic factors, becomes ossified. Due to its nature and anatomic location, OLF produces symptoms characteristic of spinal cord compression. The diagnostic confirmation is based primarily on imaging tests such as compute...

Study Design A retrospective cohort study. Objective The aim of this study is to assess the association of demographic and perioperative factors with clinical outcomes of lumbar interbody fusion with a porous nitinol (TiNi) implant for degenerative disc disease. Methods Forty-one patients with degenerative lumbar disease were prospectively follow...

In order to evaluate the predictive effect of non-invasive preoperative imaging methods on surgical outcomes of lumbar fusion for patients with degenerative disc disease (DDD) and refractory chronic axial low back pain (LBP), the authors conducted a retrospective review of 45 patients with DDD and refractory LBP submitted to anterior lumbar interbo...

In spite of being the most common primary brain tumor in adults, extracranial metastases are rarely seen during the lifetime of patients with glioblastoma. Majority of metastases occur in chest, abdomen, bone, lymph nodes, and spinal cord. Scalp lesions from glioblastoma are extremely rare, with only few cases reported in the literature. Scalp glio...

In spite of being the most common primary brain tumor in adults, extracranial metastases are rarely seen during the lifetime of patients with glioblastoma. Majority of metastases occur in chest, abdomen, bone, lymph nodes, and spinal cord. Scalp lesions from glioblastoma are extremely rare, with only few cases reported in the literature. Scalp glio...

Adipose lesions rarely affect the peripheral nerves. This can occur in two different ways: Direct compression by an extraneural lipoma, or by a lipoma originated from the adipose cells located inside the nerve. Since its first description, many terms have been used in the literature to mention intraneural lipomatous lesions. In this article, the au...

Objective To analyze the cumulative effect of risk factors associated with early major complications in postoperative spine surgery. Methods Retrospective analysis of 583 surgically-treated patients. Early “major” complications were defined as those that may lead to permanent detrimental effects or require further significant intervention. A balan...

Objective: To evaluate the efficacy of postoperative fractionated stereotactic radiosurgery (FSRS) and hypofractionated stereotactic radiotherapy (SRT) to large surgical cavities following gross-total resection of brain metastases. Methods: A retrospective analysis of 41 patients who had received tumor-bed FSRS (5 fractions) or SRT (10 fractions...

The management of spine tumors has progressively evolved over the past years. Advanced imaging modalities now allow early diagnosis of tumoral lesions and a better comprehension of the relationship between tumor, neural elements, and paraspinal structures. Also, progressive advances in surgical technology, radiation, and chemotherapy have led to th...

The objectives of spine surgery for degenerative disorders are to reduce pain and disability and improve patients’ quality of life and return to work. The incongruence between the surgeons’ perspective, results of imaging exams in terms of fusion status or adequate decompression, and patients’ satisfaction with treatment have highlighted the need t...

Background There are many controversies in the literature on the treatment of chronic subdural hematoma (CSDH). Objective To assess the effects of different surgical techniques and postoperative care on recurrence of CSDH. Methods Systematic review through Medline search of articles published between January 1990 and July 2011. Controlled observati...

A 28-year-old man presented to the emergency room with a severe headache of one day's duration. A computerized tomography scan showed a hemorrhagic tumor measuring 3.9 x 4.4 cm in the left cerebellar hemisphere. The resection specimen revealed medulloblastoma. He had two episodes of rebleeding and multiple postoperative issues preventing the use of...

OBJECTIVE Lumbar discectomy is one of the most common surgical spine procedures. In order to understand the value of this surgical care, it is important to understand the costs to the health care system and patient for good results. The objective of this study was to evaluate for the first time the cost-effectiveness of spine surgery in Latin Amer...

Vertebroplasty and kyphoplasty are widely used for osteoporotic and cancer-related vertebral compression fractures refractory to medical treatment. Many aspects of these procedures have been extensively discussed in the literature during the last few years. In this article, we perform a critical appraisal of current evidence on effectiveness and on...

OBJECTIVE: To determinate whether a surgical protocol with immediate extensive debridement, closed irrigation system and antibiotic therapy would be effective to achieve healing of deep wound infection without removing the instrumentation. METHODS: Prospective cohort study with 19 patients presenting degenerative spinal stenosis or degenerative sp...

To demonstrate the responsiveness of depression after surgery for lumbar degenerative disease and to verify the impact of this condition on surgical outcomes. A prospective cohort study with 91 patients with lumbar degenerative diseases who were evaluated preoperatively, at 30 days and 1 year postoperatively. Evolution of depression between the fol...

Introduction Despite all of the technical refinements, surgical treatment of herniated discs still remains controversial. The objective of the current prospective randomized study was to compare the outcome of patients with persistent sciatica secondary to lumbar disc herniation treated with either open discectomy (OD) or microendoscopic discectomy...

Introduction The use of clinical and functional evaluation instruments for vertebral pathologies, besides determining how the situation evolves after treatment, can predict the postoperative outcome. The objective of this study is to describe the methodology to evaluate outcome in the spinal surgery. Patients and Methods After surgical treatment i...

Introduction The incidence of motor deficits (MD) varies from 15 to 69% during the investigative or preoperative period. There seems to be no consensus regarding the precise importance of neurological impairment in determining the need for surgery and its impact on the patient's self-reported health-related quality of life (HRQoL). The objective of...

Introduction Deep wound infections are one of the most common and serious complications of spinal surgery. The impact of such infections on long-term outcomes is not well understood. The purpose of this study was to evaluate the functional status and satisfaction in patients who suffered a deep wound infection after undergoing lumbar arthrodesis fo...

Introduction Degenerative lumbar disc disease may occur in patients in different ways, according to their etiopathogeny, for instance, disc herniation, stenosis of the canal, and spondylolisthesis. The objective will be to evaluate the results of health-related quality of life measures in patients with surgically treated single-level degenerative d...

Introduction Deep wound infection (DWI) is a complication associated with poorer outcome and increased costs. The DWI rates increased in the last decade especially because of the use of spinal instrumentation. Although this condition is important for the surgical outcome, there is still no agreement about the about the need to remove the instrument...

Introduction The knowledge of prognostic factors related to good and poor surgical outcome is crucial to perform a proper patient selection and achieve a good surgical outcome. The patient satisfaction and quality of life has been considered one of the most important outcomes in spinal surgery. The objective is to report the prognosis factors relat...

Introduction Articles published on spine pathologies have been very useful, providing important information to improve diagnosis and choice of treatment. This information is even more important when it comes from the different continents, because it shows that information can be provided and applied by physicians worldwide to solve medical problems...

Introduction A previous study published by the authors showed that a single intervention could not change the base line attitudes toward neurotrauma prevention. The present study was designed to evaluate the effectiveness of multiple interventions in modifying knowledge and attitudes for the prevention of neurotrauma in Brazilian preteens and adole...

Introduction Patients with symptomatic lumbar degenerative disease can have one or more intervertebral disc involved according to several factors, such as age, smoking, weight, and profession. The objective of this study was to evaluate the outcome of patients with degenerative disease submitted to lumbar spinal fusion considering the number of lev...

Introduction Several authors have previously described their radiological methods to identify in which cases the anterior approach could be performed and when the manubriotomy was needed; nevertheless, the reproducibility of the technique was not straightforward, several different measurements were described and analyzed, without considering the va...

Introduction Lumbar discectomy is one of the most common surgical procedures, with success rates greater than 80%. To better understand the meaning of a good outcome in lumbar disc herniation treatment, it is important to know how much the health care system or the patient need to pay to achieve a good result. The cost–utility studies are useful to...

Vertebral augmentation procedures are currently widely used for osteoporotic and cancer-related vertebral compression fractures refractory to medical treatment. Many aspects of these procedures have been extensively discussed in the literature and new evidences have been emerged from recent clinical trials. In this literature review, we perform a c...

Several types of soft tissue sarcomas may locally extend to the spine. The best therapeutic strategy for such lesions strongly depends on the histological diagnosis. In this article the authors provide an up-to-date review of current guidelines regarding the management of soft tissue sarcomas involving the spine. Special attention is given to outco...

Objective: Evaluate the impact of motor deficit (MD) on pain, disability, depression and quality of life measures of patients with LDH prior to a specific treatment. Methods: A total of 254 consecutively enrolled patients with LDH associated to neurological impairment and sciatica who have not responded to conservative treatment were evaluated. Af...

Unlabelled: OBJECT.: A previous study published by the authors showed that a single intervention could not change the baseline attitudes toward neurotrauma prevention. The present study was designed to evaluate the effectiveness of multiple interventions in modifying knowledge and attitudes for the prevention of neurotrauma in Brazilian preteens a...

Cavernous malformations (CM) are formed by dilated thin-walled vascular channels without intervening parenchyma and intraventricular lesions are rare. We report a case of an intraventricular cavernoma in a 54-year old female patient. She presented with speech arrests daily for 10 months. Neurological examination revealed no deficits. The brain MRI...

Despite the small contribution of LA in the Science Citation Index (SCI), a growing contribution by LA research to international literature has been observed in recent years. Systematic review. To evaluate the scientific contribution of Latin American (LA) Spine Surgeons in the last decade. A literature search of publications by LA spinal surgeons...

To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de...