Papers by Cristiano Menezes
Coluna/columna, 2020
Objective: To describe the minimally invasive technique for the lateral retropleural approach to ... more Objective: To describe the minimally invasive technique for the lateral retropleural approach to the thoracolumbar spine and its viability in several affections of the region, demonstrating its indications, potential advantages, and necessary precautions, with an emphasis on the local anatomy, especially the diaphragm. Methods: After a review of the literature, the initial experience of the Service is reported, comparing it to the published results. The surgical technique used is described with emphasis on the surgical anatomy of the diaphragm. Results: The minimally invasive lateral retropleural approach to the thoracolumbar junction with the application of an expandable tubular retractor was described step-by-step in this study, with emphasis on the crucial points of technical execution, such as preoperative planning, access to the retropleural plane, and an orthogonal approach for adequate discectomy and/or corpectomy and subsequent implant placement. It can be used in the treatment of deformities, degenerative diseases, trauma, tumors, and infections and it allows for adequate interbody arthrodesis fusion rates associated with a smaller skin incision and less soft tissue damage, blood loss, and postoperative pain. Thus, it results in better postoperative mobility and a shorter hospital stay, which can also be observed in the data from initial experience of this Service. Conclusions: The minimally invasive technique for the lateral retropleural approach to the thoracolumbar spine with the application of an expandable tubular retractor was shown to be promising and safe for the treatment of several spinal diseases despite the complex and challenging local anatomy and it presents advantages over the morbidity rates observed in the traditional approach. Level of evidence IV; Case series.
20 Tips to Avoid and Handle Problems in the Placement of Percutaneous Pedicle Screws
World neurosurgery, 2021
OBJECTIVE Two-dimensional fluoroscopy-guided percutaneous pedicle screw (PPS) placement is curren... more OBJECTIVE Two-dimensional fluoroscopy-guided percutaneous pedicle screw (PPS) placement is currently the most widely applied instrumentation for minimally invasive treatment of spinal injuries requiring stabilization. Although this technique bears advantages over open instrumentation, it also presents new challenges and specific complications. The objective of this study is 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. MATERIAL AND METHODS The AO Spine Latin America Study Group MISS analyzed the most frequent complications and challenges occurring during the placement of over 14,000 2D-radioscopy guided PPS at different centers in the last 15 years. We describe the 20 tips we consider most relevant to perform this technique, excluding problems directly related to specific brands ...
Global Spine Journal, 2017
Introduction: A prior study showed the touched vertebra (TV), defined as the most cephalad thorac... more Introduction: A prior study showed the touched vertebra (TV), defined as the most cephalad thoracolumbar/lumbar vertebra “touched” by the center sacral vertical line (CSVL), as a potential landmark vertebra & recommended lowest instrumented vertebra (LIV) as well. We evaluated a large cohort of Lenke type 1 & 2 cases to determine if selecting the TV as the LIV will produce optimal positioning at a min. 5 yrs postoperative. Our hypothesis was that it would and that fusing short of the TV would lead to a suboptimal result. Material and Methods: 299 pts with Lenke 1 (n = 207) or Lenke 2 (n = 92) AIS curves at a min. 5 yr f/u were evaluated. The TV was selected on the preoperative x-ray by 2 independent examiners & confirmed for agreement. The LIV selected was compared to the preoperative TV as well as the LIV-CSVL distance at min. 5 yr f/u. Comparison was made on the LIV-CSVL distance in pts fused short of the TV, to the TV or distal to the TV using standard statistical software. Resul...
Influence of the Misdef Algorithm on the Therapeutic Decision for Vertebral Deformity in the Adult
Coluna\/columna, 2020
Objective The therapeutic decision in cases of adult spinal deformity takes numerous factors into... more Objective The therapeutic decision in cases of adult spinal deformity takes numerous factors into account with a consequent variability in treatment options. The objective is to compare the impact of the MISDEF (minimally invasive spine deformity) algorithm on therapeutic decisions in cases of adult spinal deformity. Methods Prospective radiographic analysis of 40 cases of adult deformity. The cases were sent, in two steps, to 20 Latin American surgeons who had to choose among six treatment options with and without the use of the MISDEF. Results For the conducts of decompression, decompression and short fusion, decompression and fusion with interbody device, and osteotomy with extension of fusion to the thoracic spine, no significant differences were found when comparing decisions made with and without MISDEF. For osteotomy, we observed a tendency for the number of surgeons choosing this conduct to increase when the decision is made with MISDEF. We observed that the number of surgeo...
Avalia��o cl�nica radiol�gica da artrodese lombar transforaminal aberta versus minimamente invasiva
Coluna Columna, 2009
Instrumentação seletiva na escoliose idiopática em curvas com modificador lombar B e C Selective fusion on idiopathic scoliosis in curves with B and C lumbar modifiers Instrumentación selectiva en la escoliosis idiopática en curvas con modificador lumbar B y C
Objective: to assess the surgical cor- rection of Adolescent Idiopathic Sco- liosis (AIS) with Se... more Objective: to assess the surgical cor- rection of Adolescent Idiopathic Sco- liosis (AIS) with Selective fusion of the thoracic curves with pedicle screws in patients with B and C Lumbar Modi- fier and to verify the magnitude of correction and safety of the technique. Methods: prospective non random- ized case series study of patients with AIS, with Lenke curves 1B, 1C, 2B and 2C treated with selective fusion of the thoracic curves. The variables were: sex, age, levels of the scolio- sis, levels fused, number of screws. Lenke's classification, pre-op Cobb's angles and pos-op Cobb's angles. Fif- ty-one patients with AIS were surgical treated from August, 2004 to October, 2007. Twenty of those fulfilled the cri - teria and were included in the study. Results: preoperative Cobb's angle mean was 51.2º and was correct to and was correct to 17.8º. The average of correction was 65.4%. Spontaneous correction of the compensatory curves was observed
Coluna/Columna, 2014
OBJECTIVE: To present some technical considerations about interbody fusion by direct lateral retr... more OBJECTIVE: To present some technical considerations about interbody fusion by direct lateral retroperitoneal transpsoas approach and its initial results. METHODS: Non-randomized prospective study of 14 patients undergoing interbody fusion via lateral approach, with evaluation of initial results and complications. RESULTS: We collected and analyzed data from 14 patients with a total of 27 levels operated. The average operative time was 146 minutes and blood loss was on average less than 50 ml. Ten patients required supplemental percutaneous fixation with pedicle screws. VAS scores for the lumbar region and lower limbs and ODI had significant improvement in the postoperative period. There was an associated case of postoperative infection and thromboembolism that required reoperations. CONCLUSION: This technique has revolutionized the care of patients requiring fusion of T6-7 to L4-5. Following the five basic steps and using intraoperative monitoring, this technique is safe and reprodu...
Diffusion-weighted magnetic resonance (DW-MR) neurography of the lumbar plexus in the preoperative planning of lateral access lumbar surgery
European Spine Journal, 2014
Coluna/Columna, 2009
OBJETIVO: a proposta deste trabalho é comparar os resultados clínicos e radiológicos dos paciente... more OBJETIVO: a proposta deste trabalho é comparar os resultados clínicos e radiológicos dos pacientes submetidos à artrodese transforaminal aberta e minimamente invasiva. MÉTODOS: quarenta e cinco pacientes foram submetidos à artrodese lombar transforaminal pelo Grupo de Cirurgia Espinhal do Hospital Lifecenter/Ortopédico de Belo Horizonte, no período de Dezembro de 2005 a Maio de 2007, sendo 15 no grupo de artrodese aberta e 30 pacientes do grupo de artrodese minimamente invasiva (MIS). As indicações para a artrodese intersomática foram: doença degenerativa do disco, associada ou não a hérnia de disco ou estenose do canal; espondilolistese de baixo grau espondilolítica ou degenerativa; e síndrome pós-laminectomia/discectomia. As variáveis analisadas foram: tempo de cirurgia, tempo de internação hospitalar, necessidade de hemotransfusão, escala analógica visual de dor (VAS) lombar e dos membros inferiores, Oswestry, índice de consolidação da artrodese e retorno ao trabalho. RESULTADOS:...
Segurança da fusão seletiva na escoliose idiopática e evolução pós-operatória
Coluna/Columna, 2013
OBJETIVOS: Analisar as correções obtidas através da instrumentação segmentar seletiva torácica, u... more OBJETIVOS: Analisar as correções obtidas através da instrumentação segmentar seletiva torácica, utilizando parafusos pediculares, em pacientes portadores de escoliose idiopática com modificador lombar B ou C; verificar a segurança da técnica e a descompensação das curvas compensatórias não instrumentadas; observar a perda de correção das curvas instrumentadas e não instrumentadas com o tempo. MÉTODOS: Estudo retrospectivo de pacientes portadores de escoliose idiopática com curvas 1B, 1C, 2B e 2C submetidos a tratamento cirúrgico por via posterior utilizando parafusos pediculares. As variáveis analisadas foram: sexo, idade, níveis acometidos pela escoliose, níveis instrumentados, número de parafusos pediculares utilizados, classificação segundo Lenke, ângulos de Cobb pré-operatórios coronal e sagital (incluindo inclinações), ângulos de Cobb no pós-operatório imediato e tardio e perda da correção das curvas com o tempo. Foram submetidos 20 pacientes portadores de escoliose idiopática ...
Instrumentação seletiva na escoliose idiopática em curvas com modificador lombar B e C Selective fusion on idiopathic scoliosis in curves with B and C lumbar modifiers Instrumentación selectiva en la escoliosis idiopática en curvas con modificador lumbar B y C
Objective: to assess the surgical cor- rection of Adolescent Idiopathic Sco- liosis (AIS) with Se... more Objective: to assess the surgical cor- rection of Adolescent Idiopathic Sco- liosis (AIS) with Selective fusion of the thoracic curves with pedicle screws in patients with B and C Lumbar Modi- fier and to verify the magnitude of correction and safety of the technique. Methods: prospective non random- ized case series study of patients with AIS, with Lenke curves 1B,
Lesöes traumáticas da coluna torácica e lombar; Traumatic injuries of the thoracic and lumbar spine
Rev. bras. ortop, 2000
... Fotocópia. Cunha, Fernando Milton da. Id: 335744. Autor: Cunha, Fernando Milton da; Menezes, ... more ... Fotocópia. Cunha, Fernando Milton da. Id: 335744. Autor: Cunha, Fernando Milton da; Menezes, Cristiano Magalhäes; Guimaräes, Eduardo Pimenta. Título: Lesöes traumáticas da coluna torácica e lombar / Traumatic injuries of the thoracic and lumbar spine. Fonte: Rev. bras. ...
Coluna/columna, 2009
Avaliação clínica radiológica da artrodese lombar transforaminal aberta versus minimamente invasi... more Avaliação clínica radiológica da artrodese lombar transforaminal aberta versus minimamente invasiva Clinical and radiological evaluation of open transforaminal lumbar interbody fusion versus minimally invasive Evaluación clínica radiológica de la artrodesis lumbar transforaminal abierta versus mínimamente invasiva
Coluna/Columna, 2012
OBJETIVO: Determinar se a abordagem MIS para artrodese lombar em um nível reduz as alterações est... more OBJETIVO: Determinar se a abordagem MIS para artrodese lombar em um nível reduz as alterações estruturais do multífido, tais como a diminuição de sua área de secção transversa e a degeneração gordurosa patológica, quando comparada a uma abordagem convencional aberta. MÉTODOS: Entre Janeiro de 2007 e Janeiro de 2010, foram avaliados 27 pacientes submetidos a procedimento cirúrgico de artrodese aberta e MIS. Realizou-se RNM no pós-operatório, no intervalo entre 12 e 36 meses após a cirurgia, com vizualizacao do músculo multífido para seu estudo. RESULTADOS: Todos os pacientes foram operados num nível de artrodese através da técnica aberta e MIS. CONCLUSÃO: Não foram encontradas diferenças significativas referentes às variáveis sexo e idade com a área e trofismo do multífido em ambos os lados.
Revista Brasileira de Ortopedia, 2008
Tratamento artroscópico da instabilidade anterior traumática do ombro: resultados a longo prazo e... more Tratamento artroscópico da instabilidade anterior traumática do ombro: resultados a longo prazo e fatores de risco 157 Rev Bras Ortop. 2008;43(5):157-66 Tratamento artroscópico da instabilidade anterior traumática do ombro: resultados a longo prazo e fatores de risco * Arthroscopic treatment of traumatic anterior instability of the shoulder: long term results and risk factors
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Papers by Cristiano Menezes