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Spinal Diseases: HELP
Articles by Ricardo Vieira Botelho
Based on 13 articles published since 2008
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Between 2008 and 2019, Ricardo Vieira Botelho wrote the following 13 articles about Spinal Diseases.
 
+ Citations + Abstracts
1 Guideline Lumbar herniated disc - endoscopic discectomy treatment. 2018

Joaquim, Andrei Fernandes / Botelho, Ricardo Vieira / Mudo, Marcelo Luis / Almeida, Antonio Silvinato de / Bernardo, Wanderley Marques. ·Brazilian Society of Neurosurgery, São Paulo, SP, Brasil. · Brazilian Medical Association, São Paulo, SP, Brasil. ·Rev Assoc Med Bras (1992) · Pubmed #30304136.

ABSTRACT: The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

2 Review Intraoperative Neurophysiological Monitoring in Spine Surgery: A Systematic Review and Meta-Analysis. 2018

Daniel, Jefferson Walter / Botelho, Ricardo Vieira / Milano, Jerônimo Buzetti / Dantas, Fernando Rolemberg / Onishi, Franz Jooji / Neto, Eloy Rusafa / Bertolini, Eduardo de Freitas / Borgheresi, Marcelo Antonio Duva / Joaquim, Andrei Fernandes. ·Neurosurgeon, Santa Casa de São Paulo - School of Medical Sciences, São Paulo, Brazil. · Neurosurgeon, Hospital do Servidor Público Estadual, São Paulo-SP, Brazil. · Neurosurgeon, Neurological Institute of Curitiba, Curitiba-PR, Brazil. · Neurosurgeon, Hospital Biocor, Belo Horizonte, Minas Gerais, Brazil. · Neurosurgeon - Federal University of São Paulo (UNIFESP), São Paulo-SP, Brazil. · Neurosurgeon - University of São Paulo (USP), São Paulo-SP, Brazil. · Neurosurgeon, Santa Casa de Santos, Santos, SP, Brazil. · Neurosurgeon - State University of Campinas (UNICAMP), Campinas-SP, Brazil. · A document from the Spine Department - Brazilian Society of Neurosurgery. ·Spine (Phila Pa 1976) · Pubmed #30063222.

ABSTRACT: STUDY DESIGN: Systematic literature review and meta-analysis. OBJECTIVE: The objective of this systematic literature review was to evaluate if intraoperative neurophysiological monitoring (IONM) can prevent neurological injury during spinal operative surgical procedures. SUMMARY OF BACKGROUND DATA: IONM seems to have presumable positive effects in identifying neurological deficits. However, the role of IONM in the decrease of new neurological deficits remains unclear. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and Meta-analysis, we reviewed clinical comparative studies who evaluate the rate of new neurological events in patients who had a spinal surgery with and without IONM. Studies were then classified according to their level of evidence. Methodological quality was assessed according to methodological index for non-randomized studies instrument. RESULTS: Six studies were evaluated comparing neurological events with and without IONM use by the random effects model. There was a great statistical heterogeneity. The pooled odds ratio (OR) was 0.72 {0.71; 1.79}, P = 0.4584. A specific analysis was done for two studies reporting the results of IONM for spinal surgery of intramedullary lesions. The OR was 0.1993 (0.0384; 1.0350), P = 0.0550. CONCLUSION: IONM did not result into fewer neurological events with the obtained evidence of the included studies. For intramedullary lesions, there was a trend to fewer neurological events in patients who underwent surgery with IONM. Further prospective randomized studies are necessary to clarify the indications of IONM in spinal surgeries. LEVEL OF EVIDENCE: 2.

3 Review The effect of posterior fossa decompression in adult Chiari malformation and basilar invagination: a systematic review and meta-analysis. 2018

de Oliveira Sousa, Ulysses / de Oliveira, Matheus Fernandes / Heringer, Lindolfo Carlos / Barcelos, Alécio Cristino Evangelista Santos / Botelho, Ricardo Vieira. ·Post-Graduation Program, Instituto de Assistencia Médica ao Servidor Publico Estadual de Sao Paulo, Sao Paulo, Brazil. · Post-Graduation Program, Instituto de Assistencia Médica ao Servidor Publico Estadual de Sao Paulo, Sao Paulo, Brazil. bitbot@uol.com.br. · , Rua Tuim 585, 122a, Vila Uberabinha, Sao Paulo, 04514-102, Brazil. bitbot@uol.com.br. ·Neurosurg Rev · Pubmed #28466256.

ABSTRACT: Chiari malformation (CM) and basilar invagination (BI) are mesodermal malformations with disproportion between the content and volume of posterior fossa capacity and overcrowding of neural structures at the level of foramen magnum. Several alternatives for posterior approaches are available, including extradural (ED), extra-arachnoidal, and intradural (ID) approaches. The objectives are to evaluate the effect of several surgical techniques for posterior fossa decompression (PFD) in the outcomes of patients with CCJM and to evaluate complications in the techniques reported. A systematic review of the literature on the effects of PFD surgery was performed using the MEDLINE (via PubMed) database and the Cochrane Central Register of Controlled Trials. The PRISMA statement and MOOSE recommendations were followed. Five hundred and thirty-nine (539) articles were initially selected by publication title. After abstract analysis, 70 articles were selected for full-text analysis, and 43 were excluded. Ultimately, 27 studies were evaluated. The success rate (SR) with ED techniques was 0.76 versus 0.81 in EA technique and 0.83 in IA technique. All posterior fossa decompression techniques were very successful. Results from observational studies were similar to that of the randomized trial. The main complications were CSF fistulas, most common in patients with IA approach. The overall mortality rate was 1%.

4 Review A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. 2010

Botelho, Ricardo Vieira / Moraes, Osmar José dos Santos / Fernandes, Gustavo Alberto / Buscariolli, Yuri dos Santos / Bernardo, Wanderley Marques. ·Neurosurgical Service, Hospital do Servidor Público do Estado de São Paulo, São Paulo, Brazil. bitbot@uol.com.br ·Neurosurg Focus · Pubmed #20568920.

ABSTRACT: OBJECT: Anterior cervical discectomy and fusion had been considered a safe and effective procedure for radiculopathy and myelopathy in the cervical spine, but degeneration in adjacent spinal levels has been a problem in some patients after fusion. Since 2002, cervical disc arthroplasty has been established as an alternative to fusion. The objective of this study was to review data concerning the role of cervical arthroplasty in reducing adjacent-level degeneration. METHODS: A systematic review was performed using the MEDLINE, EMBASE, Cochrane, and LILACS databases, focusing on a structured question involving the population of interest, types of intervention, types of control, and outcomes studied. RESULTS: No study has specifically compared the results of arthroplasty with the results of fusion with respect to the rate of postoperative development of adjacent-segment degenerative disease. One paper described a rate for adjacent-level surgery. The level of evidence of that paper was classified 2b, and although its authors found a statistically significant between-groups difference (arthroplasty vs fusion) using log-rank analysis, re-analysis according to number needed to treat (in the current paper) did not reveal statistical significance. CONCLUSIONS: Adjacent-level degeneration has not been adequately studied in a review of the available randomized controlled trials on this topic, and there is no clinical evidence of reduction in adjacent-level degeneration with the use of cervical arthroplasty.

5 Article Intraoperative vancomycin powder and post-operative infection after spinal surgery: a systematic review and meta-analysis. 2019

Joaquim, Andrei Fernandes / Milano, Jerônimo Buzetti / Daniel, Jefferson Walter / Dantas, Fernando Rolemberg / Onishi, Franz / Russafa Neto, Eloy / Bertolini, Eduardo de Freitas / Borgueresi, Marcelo Duva / Mudo, Marcelo L / Botelho, Ricardo Vieira. ·Neurosurgeon - State University of Campinas (UNICAMP), Campinas-SP, Brasil. · Neurosurgeon - Neurological Institute of Curitiba, Curitiba-PR, Brasil. · Professor of Neurosurgery - Santa Casa de São Paulo, São Paulo-SP, Brasil. · Neurosurgeon - Hospital Biocor - Belo Horizonte-MG, and Post-Graduation Program, Hospital do Servidor Público Estadual, São Paulo-SP, Brasil. · Neurosurgeon - Federal University of São Paulo (UNIFESP) - São Paulo-SP, Brasil. · Neurosurgeon - University of São Paulo (USP), São Paulo-SP, Brasil. · Neurosurgeon - Hospital do Servidor Público Estadual, São Paulo-SP, Brasil. · Neurosurgeon - Hospital São Camilo - Itu-SP, Brasil. ·Rev Assoc Med Bras (1992) · Pubmed #30892452.

ABSTRACT:

6 Article Basilar Invagination: A Craniocervical Kyphosis. 2018

Botelho, Ricardo Vieira / Ferreira, Jânio Alves / Zandonadi Ferreira, Edson Dener. ·Post-graduation Program, Hospital do Servidor Público Estadual, São Paulo, Brazil. Electronic address: bitbot@uol.com.br. · Post-graduation Program, Hospital do Servidor Público Estadual, São Paulo, Brazil. ·World Neurosurg · Pubmed #29886302.

ABSTRACT: BACKGROUND: For more than a century, odontoid process prolapse, which compresses cranial base structures, has been the hallmark of basilar invagination (BI). The angulation of the whole skull toward the cervical spine may be considered to contribute to BI and odontoid prolapse. The objective of this study was to evaluate the craniocervical angular craniometry of patients with BI compared with patients with Chiari malformation (CM) and normal subjects. METHODS: Angular craniocervical relationships among midline magnetic resonance imaging scans from patients with BI, patients with CM, and normal subjects were evaluated and compared. Angles were measured by Meazure 2.0 software from digitalized images. RESULTS: Using data from 121 images, 42 patients with BI (14 type I BI, 28 type II BI), 47 patients with CM, and 32 control subjects were evaluated. The BI group had a more acute kyphotic angle than the CM group (P < 0.01) and control group. The kyphosis difference was 17.57 ± 2.3° (P < 0.01) between the BI and CM groups and 21.19 ± 2.3° (P < 0.01) between the BI and control groups. Basal angles were significantly larger in the BI group compared with the other 2 groups. A strong correlation was found with kyphosis and CLV and the clivus-canal angle and cervical lordosis angle (P < 0.01). CONCLUSIONS: Craniocervical kyphosis in patients with BI was approximately 20° greater than in normal subjects and patients with CM. Craniocervical kyphosis should be considered a pathophysiologic condition in BI.

7 Article Is there a relationship between spinal instability in neoplastic disease and Tokuhashi scoring system? 2016

de Oliveira, Matheus Fernandes / Rotta, Jose Marcus / Botelho, Ricardo Vieira. ·Department of Neurosurgery, Hospital do Servidor Público Estadual de São Paulo, IAMSPE, Av. Loefgren, 700, apto 103, Vila Clementino, Indianópolis, São Paulo, 04040-000, Brazil. mafernoliv@yahoo.com.br. · Department of Neurosurgery, Hospital do Servidor Público Estadual de São Paulo, IAMSPE, Av. Loefgren, 700, apto 103, Vila Clementino, Indianópolis, São Paulo, 04040-000, Brazil. ·Neurosurg Rev · Pubmed #26860530.

ABSTRACT: Spinal instability neoplastic score (SINS) classification evaluates spinal stability by adding together six radiographic and clinical components. The objective of this study was to verify the association between SINS and Tokuhashi scoring system (TSS) score. Fifty-eight patients with vertebral metastases were admitted from 2010 to 2014 at Hospital do Servidor Público Estadual de São Paulo. They were evaluated according to their SINS and Tokuhashi SS score. Fourteen patients (24.13 %) scored from 0 to 6 points (stable spine), 37 (63.79 %) scored from 7 to 12 (potentially unstable), and 7 (12.06 %) scored from 13 to 18 (unstable). In stable spine patients according to SINS, the mean TSS score was 9.2. In potentially unstable spine patients, the mean TSS score was 8.24. In unstable spine patients, mean TSS score was 6.28. There was a statistically significant difference of the TSS score between stable and unstable patients. After evaluating TSS score in each patient, the worse the SINS, the worse was also the TSS score.

8 Article Survival analysis in patients with metastatic spinal disease: the influence of surgery, histology, clinical and neurologic status. 2015

Oliveira, Matheus Fernandes de / Rotta, Jose Marcus / Botelho, Ricardo Vieira. ·Departamento de Neurocirurgia, Hospital do Servidor Público Estadual de São Paulo, Sao Paulo, SP, Brazil. ·Arq Neuropsiquiatr · Pubmed #25992524.

ABSTRACT: METHOD: The study sample consisted of consecutive patients admitted from July 2010 to January 2013 for treatment. RESULTS: Sixty eight patients were evaluated. 23 were female and 45 were male. Main primary neoplasic sites were: breast, prostate, lung/pleura and linfoproliferative. Thirty three out of 68 received surgical treatment, 2 received percutaneous biopsy and 33 had nonsurgical treatment. SURVIVAL: Log Rank curves revealed no statistical significant difference according to histological type, surgical approach and Frankel Score. Karnofsky Score was statistically different. CONCLUSION: Histological type and clinical status were statistically associated with life expectancy in vertebral metastatic disease.

9 Article Tokuhashi Scoring System has limited applicability in the majority of patients with spinal cord compression secondary to vertebral metastasis. 2013

Oliveira, Matheus Fernandes de / Barros, Breno de Amorim / Rotta, Jose Marcus / Botelho, Ricardo Vieira. · ·Arq Neuropsiquiatr · Pubmed #24212518.

ABSTRACT: Spine is the primary bone site affected by systemic metastasis. Although there are scales that attempt to manage these patients, their real applicability is unknown. The Tokuhashi Scoring System (TSS) is a widely used prognostic tool. At the time of treatment, the data necessary to complete TSS may be incomplete, making its application impossible. Objective To evaluate the number of TSS scores completed by the time the clinical therapeutic decision was made. Methods From July 2010 to January 2012, we selected patients who were diagnosed with spinal metastases. Results Sixty spinal metastasis patients (21 female, 39 male) were evaluated between July 2010 and January 2012. At the time of the treatment decision, only 25% of the patients had completed the TSS items. Conclusion In the majority of patients with vertebral metastasis, TSS variables cannot be applied.

10 Article Assessing the evolution of publications by Brazilian spine surgeons in the last decade. 2013

Falavigna, Asdrubal / Botelho, Ricardo Vieira / Teles, Alisson Roberto / da Silva, Pedro Guarise / Defino, Helton Luiz Aparecido. ·Medical Faculty of the University of Caxias do Sul, Rua General Arcy da Rocha Nóbrega, 401/602, Caxias do Sul, RS, 95040-290, Brazil, asdrubalmd@gmail.com. ·Eur Spine J · Pubmed #23700230.

ABSTRACT: PURPOSE: To evaluate the scientific contribution of Brazilian Spine Surgeons not only in number of publications but also in their quality between January 2000 to December 2011. METHODS: A literature search of publications by Brazilian spinal surgeons on topics concerning the spine or spinal cord was performed using an online database; Pubmed.gov. The results were limited to articles published from January 2000 to December 2011. A total of 1,778 articles were identified after a Medline search. After exclusion criteria, the study comprised 206 articles. The quality of the Journals was assessed with IF and the article quality using the Oxford classification. RESULTS: An increasing number of publications by Brazilian spine surgeons was observed in recent years: 45.1 % of those papers were published during the last 4 years (2008-2011). Clinical studies and case reports were the most frequent types of article published (37.5 vs 31.1 %). An increasing number of Brazilian publications in non-Brazilian journals has been observed in recent years (linear-by-linear association: 5.449, P = 0.020). The Arquivos de Neuro-Psiquiatria was the most frequent journal in which the papers were published (N = 67, 32 %). The IF of the publications varied from 0.021 to 8.017. The analysis of quality of the articles using the Oxford classification demonstrated that most of them provided LOE 4 (N = 113, 54.9 %) or 5 (N = 45, 21.8 %). CONCLUSIONS: There have been an increasing number of publications by Brazilian spine surgeons in recent years and the quality of the articles published has improved. Also the number of publications by Brazilians in non-Brazilian journals has increased in recent years.

11 Article Angular craniometry in craniocervical junction malformation. 2013

Botelho, Ricardo Vieira / Ferreira, Edson Dener Zandonadi. ·Post-graduation Program in Health Sciences-IAMSPE-São Paulo, São Paulo, Brazil, bitbot@uol.com.br. ·Neurosurg Rev · Pubmed #23640096.

ABSTRACT: The craniometric linear dimensions of the posterior fossa have been relatively well studied, but angular craniometry has been poorly studied and may reveal differences in the several types of craniocervical junction malformation. The objectives of this study were to evaluate craniometric angles compared with normal subjects and elucidate the main angular differences among the types of craniocervical junction malformation and the correlation between craniocervical and cervical angles. Angular craniometries were studied using primary cranial angles (basal and Boogard's) and secondary craniocervical angles (clivus canal and cervical spine lordosis). Patients with basilar invagination had significantly wider basal angles, sharper clivus canal angles, larger Boogard's angles, and greater cervical lordosis than the Chiari malformation and control groups. The Chiari malformation group does not show significant differences when compared with normal controls. Platybasia occurred only in basilar invagination and is suggested to be more prevalent in type II than in type I. Platybasic patients have a more acute clivus canal angle and show greater cervical lordosis than non-platybasics. The Chiari group does not show significant differences when compared with the control, but the basilar invagination groups had craniometric variables significantly different from normal controls. Hyperlordosis observed in the basilar inavagination group was associated with craniocervical kyphosis conditioned by acute clivus canal angles.

12 Article Assessing the evolution of publications by Brazilian spine surgeons in the last decade. 2013

Falavigna, Asdrubal / Botelho, Ricardo Vieira / Teles, Alisson Roberto / da Silva, Pedro Guarise / Defino, Helton Luiz Aparecido. ·Department of Neurosurgery, Medical School of the University of Caxias do Sul, Caxias do Sul RS, Brazil. Electronic address: asdrubalmd@gmail.com. ·World Neurosurg · Pubmed #22728665.

ABSTRACT: -- No abstract --

13 Article Is there a benefit to operating on patients (bedridden or in wheelchairs) with advanced stage cervical spondylotic myelopathy? 2010

Scardino, Fabrizio Borges / Rocha, Leonardo Poubel / Barcelos, Alécio Cristino Evangelista Santos / Rotta, José Marcus / Botelho, Ricardo Vieira. ·Spine Surgery Section, Hospital do Servidor Público Estadual de São Paulo, São Paulo, Brazil. fabriziobs@bol.com.br ·Eur Spine J · Pubmed #20069318.

ABSTRACT: Surgical treatment of cervical spondylotic myelopathy (CSM) aims to prevent or delay the progression of the disease. Many patients are diagnosed in advanced stages of the disease, presenting severe functional disability and extensive radiologic changes, which suggests clinical irreversibility. There are doubts about the real benefit of surgery in patients who are seriously ill, bedridden or in a wheelchair. The objective of the study is to evaluate the effects of surgical treatment in the clinical outcomes of patients severely affected by CSM. We analyzed patients with CSM who received an operation at a single institution between 1996 and 2008. Cases with a preoperative Nurick score equal to 5 were studied. We describe postoperative clinical improvement and compare the demographics and clinical data between the patients who improved and those who had no improvement. Radiological findings were also analyzed. We evaluated 55 patients operated on. Nine presented with preoperative Nurick score of 5 (16.3%). The mean age was 69.77 +/- 6.6 years (95% CI 64.65-79.90). The mean follow-up was 53.44 +/- 35.09 months (CI 26.46-80.42). Six patients (66.6%) achieved functional improvement when assessed by the Nurick scale, regaining the ability to walk. All patients improved on the JOAm scale, except one. The mean preoperative Nurick score was 5, while the mean postoperative Nurick score was 4.11 +/- 0.92 (95% CI 3.39-4.82) (Wilcoxon p = 0.027). The mean preoperative JOAm score was 6.4, and postoperative was 9.88 +/- 2.31 (CI 95% 8.10-11.66) (Wilcoxon p = 0.011). All spinal cords presented high-intensity signal on T2-weighted images. There was no correlation between the number of spinal cord high-intensity signal levels and clinical improvement. Three out of seven patients (whose image was adequate for analysis) had evident spinal cord atrophy, and two of them did not improve clinically. In the whole sample of patients, the mean length of disease for those who improved was 9.25 +/- 7.31 months (95% CI 1.56-16.93), and for those who did not improve was 38.00 +/- 19.28 months (95% CI 9.91-85.91) (Mann-Whitney p = 0.02). In conclusion, two-thirds of patients with CSM Nurick scores of 5 who were either bedridden or in wheelchairs at the time of diagnosis improved at least one degree on the Nurick scale after surgical treatment, thus returning to walking. The JOAm scale was more sensitive to clinical changes than the Nurick scale. Patients with longer lengths of disease had worse outcomes.