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Autor Giraldo García, Gustavo
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Documentos disponibles escritos por este autor (3)
Clasificado(s) por (Año de edición descendente) Refinar búsquedaComparative analysis of surgical approaches in nonsyndromic multiple-suture synostosis: a systematic review and meta-analysis / Giraldo García, Gustavo ; Gutiérrez Pineda, Felipe ; Franklin, Brodus A ; Punukollu, Anuraag ; Chen, Hsien Chung ; Machado Silva, Anna Lydia ; Proctor, Mark ; Quiceno, Esteban
Título : Comparative analysis of surgical approaches in nonsyndromic multiple-suture synostosis: a systematic review and meta-analysis Tipo de documento : documento electrónico Autores : Giraldo García, Gustavo, Autor ; Gutiérrez Pineda, Felipe, Autor ; Franklin, Brodus A, Autor ; Punukollu, Anuraag, Autor ; Chen, Hsien Chung, Autor ; Machado Silva, Anna Lydia, Autor ; Proctor, Mark, Autor ; Quiceno, Esteban, Autor Fecha de publicación : 2025 Títulos uniformes : Journal of Neurosurgery: Pediatrics Idioma : Inglés (eng) Idioma original : Inglés (eng) Palabras clave : craniofacial; craniosynostosis; endoscopic surgery; meta-analysis; nonsyndromic multiple-suture synostosis; open surgery. Resumen : Objective: Nonsyndromic multiple-suture synostosis (MSS) is one of the rarest types of craniosynostosis. While both endoscopic and open surgical approaches have demonstrated efficacy for MSS patients, a comprehensive comparison of perioperative outcomes between the two approaches has yet to be fully explored. The aim of this systematic review and meta-analysis was to assess the available evidence among the two surgical approaches to better inform the management of complex craniosynostosis. Methods: PubMed, Embase, and Scopus were searched for studies published from the first reports through February 2024 that reported surgical outcomes of either endoscopic or open surgery for nonsyndromic MSS. The main outcome was the reoperation rate, with secondary endpoints including transfusion rates, intraoperative complications, and overall complications, with a subgroup analysis conducted for patients with nonsyndromic bicoronal synostosis.Results: Sixteen studies involving 310 patients were analyzed. Patients undergoing open surgery were older than those treated with endoscopy (mean age 10.39 vs 3.21 months). The pooled analysis showed a reoperation rate of 11% (95% CI 4%-23%, I2 = 25%) for endoscopic surgery compared with 22% (95% CI 14%-31%, I2 = 0) for open surgery (p = 0.11). Transfusion rates were 26% (95% CI 13%-45%, I2 = 50%) for endoscopic surgery and 50% (95% CI 22%-78%, I2 = 71%) for open surgery (p = 0.18). Intraoperative complications were similar: 17% (95% CI 7%-34%, I2 = 0%) for endoscopic vs 15% (95% CI 4%-42%, I2 = 76%) for open surgery (p = 0.85). Overall complication rates were 15% (95% CI 7%-31%, I2 = 45%) for endoscopic surgery and 20% (95% CI 9%-38%, I2 = 65%) for open surgery (p = 0.59). In the subgroup analysis of bicoronal synostosis, the reoperation rate was 10% (95% CI 4%-21%, I2 = 0%) for endoscopic surgery versus 16% (95% CI 7%-32%, I2 = 0%) for open surgery (p = 0.39).Conclusions: While both surgical approaches are reasonable options for nonsyndromic MSS, this meta-analysis suggests that endoscopic surgery could be associated with lower morbidity when compared with open surgery. Future studies with longer follow-up periods will be needed to validate these findings and contribute to the understanding of complex craniosynostosis management. Mención de responsabilidad : Felipe Gutierrez Pineda, Brodus A. Franklin MHA, MBA, Anuraag Punukollu MBBS, Hsien-Chung Chen MD, Gustavo Giraldo Garcia MD, Anna Lydia Machado Silva, Mark Proctor MD, and Esteban Quiceno Referencia : J Neurosurg Pediatr . 2025 Mar 7;35(5):449-459. DOI (Digital Object Identifier) : 10.3171/2024.11.PEDS24364 Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/40053929/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Comparative analysis of surgical approaches in nonsyndromic multiple-suture synostosis: a systematic review and meta-analysis [documento electrónico] / Giraldo García, Gustavo, Autor ; Gutiérrez Pineda, Felipe, Autor ; Franklin, Brodus A, Autor ; Punukollu, Anuraag, Autor ; Chen, Hsien Chung, Autor ; Machado Silva, Anna Lydia, Autor ; Proctor, Mark, Autor ; Quiceno, Esteban, Autor . - 2025.
Obra : Journal of Neurosurgery: Pediatrics
Idioma : Inglés (eng) Idioma original : Inglés (eng)
Palabras clave : craniofacial; craniosynostosis; endoscopic surgery; meta-analysis; nonsyndromic multiple-suture synostosis; open surgery. Resumen : Objective: Nonsyndromic multiple-suture synostosis (MSS) is one of the rarest types of craniosynostosis. While both endoscopic and open surgical approaches have demonstrated efficacy for MSS patients, a comprehensive comparison of perioperative outcomes between the two approaches has yet to be fully explored. The aim of this systematic review and meta-analysis was to assess the available evidence among the two surgical approaches to better inform the management of complex craniosynostosis. Methods: PubMed, Embase, and Scopus were searched for studies published from the first reports through February 2024 that reported surgical outcomes of either endoscopic or open surgery for nonsyndromic MSS. The main outcome was the reoperation rate, with secondary endpoints including transfusion rates, intraoperative complications, and overall complications, with a subgroup analysis conducted for patients with nonsyndromic bicoronal synostosis.Results: Sixteen studies involving 310 patients were analyzed. Patients undergoing open surgery were older than those treated with endoscopy (mean age 10.39 vs 3.21 months). The pooled analysis showed a reoperation rate of 11% (95% CI 4%-23%, I2 = 25%) for endoscopic surgery compared with 22% (95% CI 14%-31%, I2 = 0) for open surgery (p = 0.11). Transfusion rates were 26% (95% CI 13%-45%, I2 = 50%) for endoscopic surgery and 50% (95% CI 22%-78%, I2 = 71%) for open surgery (p = 0.18). Intraoperative complications were similar: 17% (95% CI 7%-34%, I2 = 0%) for endoscopic vs 15% (95% CI 4%-42%, I2 = 76%) for open surgery (p = 0.85). Overall complication rates were 15% (95% CI 7%-31%, I2 = 45%) for endoscopic surgery and 20% (95% CI 9%-38%, I2 = 65%) for open surgery (p = 0.59). In the subgroup analysis of bicoronal synostosis, the reoperation rate was 10% (95% CI 4%-21%, I2 = 0%) for endoscopic surgery versus 16% (95% CI 7%-32%, I2 = 0%) for open surgery (p = 0.39).Conclusions: While both surgical approaches are reasonable options for nonsyndromic MSS, this meta-analysis suggests that endoscopic surgery could be associated with lower morbidity when compared with open surgery. Future studies with longer follow-up periods will be needed to validate these findings and contribute to the understanding of complex craniosynostosis management. Mención de responsabilidad : Felipe Gutierrez Pineda, Brodus A. Franklin MHA, MBA, Anuraag Punukollu MBBS, Hsien-Chung Chen MD, Gustavo Giraldo Garcia MD, Anna Lydia Machado Silva, Mark Proctor MD, and Esteban Quiceno Referencia : J Neurosurg Pediatr . 2025 Mar 7;35(5):449-459. DOI (Digital Object Identifier) : 10.3171/2024.11.PEDS24364 Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/40053929/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Efficacy and safety of sagittal synostosis surgery in older (> 12 months) patients: a systematic review and meta-analysis Tipo de documento : documento electrónico Autores : Giraldo García, Gustavo, Autor ; Ignacio Alberto González Borrero, Autor ; Gutiérrez Pineda, Felipe, Autor ; Franklin, Brodus A, Autor ; Punukollu, Anuraag, Autor Fecha de publicación : 2024 Títulos uniformes : Child's Nervous System Idioma : Inglés (eng) Palabras clave : Craniosynostosis; Isolated sagittal synostosis; Older patients; Outcomes; Surgery. Resumen : Purpose: Sagittal synostosis is the most common isolated craniosynostosis. Surgical treatment of this synostosis has been extensively described in the global literature, with promising outcomes when it is performed in the first 12 months of life. However, in some cases, patients older than 12 months arrive at the craniofacial center with this synostosis. A comprehensive study on efficacy and perioperative outcomes has yet to be fully explored in this population. This systematic review and meta-analysis aimed to assess the available evidence of surgical outcomes for the treatment of sagittal synostosis among older patients to analyze the efficacy and safety of synostosis surgery in this unique population. Methods: PubMed, Embase, and Scopus were searched for studies published from inception to March 2024 reporting surgical outcomes of synostosis surgery in older patients (> 12 months) with isolated sagittal synostosis. The main outcome was the reoperation rate, with secondary endpoints including transfusion rates, aesthetic outcomes, and surgical complications. Results: Nine studies were included in the final analysis. The pooled proportion of the reoperation rate was 1%. The rate of excellent aesthetic results was 95%. The need for transfusion associated with the procedures was 86%, and finally, surgical complications attained a pooled ratio of 2%, indicating minimal morbidity associated with the surgical repair. Conclusion: Sagittal synostosis surgery is a safe and effective procedure to perform in older patients; this meta-analysis suggests that open surgery confers a significant rate of excellent aesthetic results with a low reoperation rate and minimal complications associated with the intervention. Future research with direct comparisons among different techniques will validate the findings of this study, which will all contribute to the rigor of synostosis management. Mención de responsabilidad : Felipe Gutierrez-Pineda, Brodus A. Franklin, Anuraag Punukollu, Gustavo Giraldo Garcia, Oscar Eduardo Moreno Duque, Haiber Arias Renteria, Juan Felipe Pelaez Perez & Ignacio Alberto Gonzalez Referencia : Childs Nerv Syst . 2024 Sep;40(9):2801-2809 DOI (Digital Object Identifier) : 10.1007/s00381-024-06472-y. PMID : 38856746 Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/38856746/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Efficacy and safety of sagittal synostosis surgery in older (> 12 months) patients: a systematic review and meta-analysis [documento electrónico] / Giraldo García, Gustavo, Autor ; Ignacio Alberto González Borrero, Autor ; Gutiérrez Pineda, Felipe, Autor ; Franklin, Brodus A, Autor ; Punukollu, Anuraag, Autor . - 2024.
Obra : Child's Nervous System
Idioma : Inglés (eng)
Palabras clave : Craniosynostosis; Isolated sagittal synostosis; Older patients; Outcomes; Surgery. Resumen : Purpose: Sagittal synostosis is the most common isolated craniosynostosis. Surgical treatment of this synostosis has been extensively described in the global literature, with promising outcomes when it is performed in the first 12 months of life. However, in some cases, patients older than 12 months arrive at the craniofacial center with this synostosis. A comprehensive study on efficacy and perioperative outcomes has yet to be fully explored in this population. This systematic review and meta-analysis aimed to assess the available evidence of surgical outcomes for the treatment of sagittal synostosis among older patients to analyze the efficacy and safety of synostosis surgery in this unique population. Methods: PubMed, Embase, and Scopus were searched for studies published from inception to March 2024 reporting surgical outcomes of synostosis surgery in older patients (> 12 months) with isolated sagittal synostosis. The main outcome was the reoperation rate, with secondary endpoints including transfusion rates, aesthetic outcomes, and surgical complications. Results: Nine studies were included in the final analysis. The pooled proportion of the reoperation rate was 1%. The rate of excellent aesthetic results was 95%. The need for transfusion associated with the procedures was 86%, and finally, surgical complications attained a pooled ratio of 2%, indicating minimal morbidity associated with the surgical repair. Conclusion: Sagittal synostosis surgery is a safe and effective procedure to perform in older patients; this meta-analysis suggests that open surgery confers a significant rate of excellent aesthetic results with a low reoperation rate and minimal complications associated with the intervention. Future research with direct comparisons among different techniques will validate the findings of this study, which will all contribute to the rigor of synostosis management. Mención de responsabilidad : Felipe Gutierrez-Pineda, Brodus A. Franklin, Anuraag Punukollu, Gustavo Giraldo Garcia, Oscar Eduardo Moreno Duque, Haiber Arias Renteria, Juan Felipe Pelaez Perez & Ignacio Alberto Gonzalez Referencia : Childs Nerv Syst . 2024 Sep;40(9):2801-2809 DOI (Digital Object Identifier) : 10.1007/s00381-024-06472-y. PMID : 38856746 Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/38856746/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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Título : Navigating the Indeterminate Zone: Surgeons' Decision-Making Factors in Treating Vertebral Metastases with Spinal Instability Scores of 7-12 Tipo de documento : documento electrónico Autores : Giraldo García, Gustavo, Autor Fecha de publicación : 2024 Títulos uniformes : World Neurosurgery Idioma : Inglés (eng) Palabras clave : SINS; Spinal instability; Spinal metastases; Spine; Spine tumor. Resumen : Background: The Spinal Instability Neoplastic Score (SINS) classification system is a validated and the most widely accepted instrument for defining instability in vertebral metastasis (VM), in which lesions scoring between 7 and 12 are defined as indeterminate and the treatment is controversial. This study aimed to determine which variables more frequently are considered by spine surgeons for choosing between the conservative and the surgical treatment of VMs among patients with an indeterminate SINS. Methods: A single-round online survey was conducted with 10 spine surgeons with expertise in the management of VMs from our AO Spine Region. In this survey, each surgeon independently reviewed demographic and cancer-related variables of 36 real-life cases of patients with vertebral metastases scored between 7 and 12 in the SINS. Bivariate and multivariate analyses were performed to identify significant SINS and non-SINS variables influencing the decision-making on surgical treatment. Results: The most commonly variables considered important were the SINS element "mechanical pain", rated important for 44.4% of the cases, "lesion type" for 36.1%, and "degree of vertebral collapse" and the non-SINS factor "tumor histology" rated for 13.9% of cases. By far the factor most commonly rated unimportant was "posterior element compromise" (in 72.2% of cases). Conclusions: Surgeons relied on mechanical pain and type of metastatic lesion for treatment choices. Vertebral collapse, spinal malalignment, and mobility were less influential. Spinal mobility was a predictor of surgical versus non-surgical treatment. The only variables not identified either by surgeons themselves or as a predictor of surgery selection was the presence/degree of posterolateral/posterior element involvement. Mención de responsabilidad : Landriel, Federico; White, Kevin; Guiroy, Alfredo; Silva, Álvaro; Carazzo, Charles; Simões, Christiano; Giraldo, Gustavo; Cabrera, Juan Pablo; Molina, Marcelo; Valacco, Marcelo; Astur, Nelson; Teixeira, William Referencia : World Neurosurg . 2024 May:185:e1338-e1347 DOI (Digital Object Identifier) : 10.1016/j.wneu.2024.03.084. Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/38521221/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Navigating the Indeterminate Zone: Surgeons' Decision-Making Factors in Treating Vertebral Metastases with Spinal Instability Scores of 7-12 [documento electrónico] / Giraldo García, Gustavo, Autor . - 2024.
Obra : World Neurosurgery
Idioma : Inglés (eng)
Palabras clave : SINS; Spinal instability; Spinal metastases; Spine; Spine tumor. Resumen : Background: The Spinal Instability Neoplastic Score (SINS) classification system is a validated and the most widely accepted instrument for defining instability in vertebral metastasis (VM), in which lesions scoring between 7 and 12 are defined as indeterminate and the treatment is controversial. This study aimed to determine which variables more frequently are considered by spine surgeons for choosing between the conservative and the surgical treatment of VMs among patients with an indeterminate SINS. Methods: A single-round online survey was conducted with 10 spine surgeons with expertise in the management of VMs from our AO Spine Region. In this survey, each surgeon independently reviewed demographic and cancer-related variables of 36 real-life cases of patients with vertebral metastases scored between 7 and 12 in the SINS. Bivariate and multivariate analyses were performed to identify significant SINS and non-SINS variables influencing the decision-making on surgical treatment. Results: The most commonly variables considered important were the SINS element "mechanical pain", rated important for 44.4% of the cases, "lesion type" for 36.1%, and "degree of vertebral collapse" and the non-SINS factor "tumor histology" rated for 13.9% of cases. By far the factor most commonly rated unimportant was "posterior element compromise" (in 72.2% of cases). Conclusions: Surgeons relied on mechanical pain and type of metastatic lesion for treatment choices. Vertebral collapse, spinal malalignment, and mobility were less influential. Spinal mobility was a predictor of surgical versus non-surgical treatment. The only variables not identified either by surgeons themselves or as a predictor of surgery selection was the presence/degree of posterolateral/posterior element involvement. Mención de responsabilidad : Landriel, Federico; White, Kevin; Guiroy, Alfredo; Silva, Álvaro; Carazzo, Charles; Simões, Christiano; Giraldo, Gustavo; Cabrera, Juan Pablo; Molina, Marcelo; Valacco, Marcelo; Astur, Nelson; Teixeira, William Referencia : World Neurosurg . 2024 May:185:e1338-e1347 DOI (Digital Object Identifier) : 10.1016/j.wneu.2024.03.084. Derechos de uso : CC BY-NC-ND En línea : https://pubmed.ncbi.nlm.nih.gov/38521221/ Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
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