MARIO AUGUSTO TARICCO
Projetos de Pesquisa
Unidades Organizacionais
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
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- Intraoperative Ultrasound in Chiari Type I Malformation(2020) BROCK, R. S.; TARICCO, M. A.; OLIVEIRA, M. F. De; OLIVEIRA, M. De Lima; TEIXEIRA, M. J.; BOR-SENG-SHU, E.The advent of intraoperative ultrasonography (USG) has allowed identification of craniocervical junction (CVJ) anatomy and cerebrospinal fluid dynamics and CVJ structures with real-time images. It is possible to use intraoperative USG in patients with Chiari malformation type I as a method for selection of candidates for posterior fossa decompression with bone removal alone. This chapter describes the authors’ experience using intraoperative USG. © Springer Nature Switzerland AG 2020.
- Intraoperative Ultrasonography for Definition of Less Invasive Surgical Technique in Patients with Chiari Type I Malformation(2017) BROCK, Roger Schmidt; TARICCO, Mario Augusto; OLIVEIRA, Matheus Fernandes de; OLIVEIRA, Marcelo de Lima; TEIXEIRA, Manoel Jacobsen; BOR-SENG-SHU, EdsonINTRODUCTION: Chiari malformation type I (CM) is the main congenital malformation disease of the craniovertebral junction. The ideal surgical treatment is still controversial. Invasive procedures inside the cerebrospinal fluid (CSF) space and associated with dural repair are considered the gold standard; however, less invasive surgery with isolated bone decompression without dural opening may be possible in selected patients. Our study evaluates the efficacy of intraoperative CSF flow measurement with ultrasonography (USG) as a determining parameter in the selection of these patients. METHODS: We analyzed prospectively 49 patients with CM operated on at the Hospital das Clinicas, College of Medicine, University of Sao Paulo. Patients underwent decompressive surgery with or without opening of the dura mater after intraoperative USG measuring flow rate. A value of 3 cm/second was considered a cutoff. Quality of life before and after surgery and the improvement of neck pain and headache were evaluated. RESULTS: Among 49 patients enrolled, 36 patients (73%) had CSF flow >3 cm/second and did not undergo duraplasty. In 13 patients (27%) with initial flow <3 cm/second, dural opening was performed together with duraplasty. All patients improved when preoperative and postoperative scores were compared, and all clinical parameters evaluated did not differ between both surgical groups. Patients submitted to bone decompression alone had a lower complication rate. CONCLUSIONS: Intraoperative USG with measurement of CSF allows the proper selection of patients with CM for less invasive surgery with bone decompression without duraplasty.
- Avaliação das técnicas cirúrgicas para tratamento da mielorradiculopatia espondilótica cervical(2012) MELUZZI, Alexandre; TARICCO, Mário Augusto; BROCK, Roger Schimidt; DIAS, Mário Rubem Pena; NAKAGUAWA, Gilberto; GUIRADO, Vinícius Monteiro de Paula; TEIXEIRA, Manoel JacobsenOBJECTIVE: To evaluate the efficacy of surgical treatment of cervical spondylotic myeloradiculopathy in the production of postoperative neurological improvement, measured in points by the scale of JOA (Japanese Orthopaedic Association) and the recovery rate and complications of therapy. METHODS: Analysis of medical records and imaging studies of 200 patients undergoing surgical treatment of cervical myeloradiculopathy in HC-FMUSP, from January 1993 to January 2007. Clinical evaluation was quantified by the scale of the JOA, with an average follow-up of 6 years and 8 months. RESULTS: There was post-operative neurological improvement in the anterior and posterior approach, except in laminectomy without fusion, where late neurological deterioration was observed. The anterior approach showed a significantly higher rate of complications related to poor fusion, intervertebral displacement of the graft, adjacent disc syndrome, dysphonia, dysphagia, poor positioning of the graft and plates, nerve root injury and significant higher rate of re-operation. In the posterior approach, increased occurrence of instability and kyphosis in the postoperative, in laminectomy were found, whereas in laminoplasty these conditions were not observed, presenting similar rates to those found for the anterior approach. There was no improvement in axial pain in the laminoplasties and worsening in laminectomies, whereas in discectomias and corpectomias there was significant relief of symptoms. CONCLUSION: The anterior and posterior routes were effective in producing neurological improvement, except for laminectomy without fusion. The anterior approach produced more complications, but is better for pain treatment.
- Reliability and safety of a new upper cervical spine injury treatment algorithm(2017) JOAQUIM, Andrei Fernandes; BROCK, Roger Schmidt; GUIRADO, Vinicius Monteiro de Paula; SANDON, Luis Henrique; SILVA, Otavio Turolo da; TARICCO, Mario Augusto; TEIXEIRA, Manoel Jacobsen; FIGUEIREDO, Eberval GadelhaIn the present study, we evaluated the reliability and safety of a new upper cervical spine injury treatment algorithm to help in the selection of the best treatment modality for these injuries. Methods: Thirty cases, previously treated according to the new algorithm, were presented to four spine surgeons who were questioned about their personal suggestion for treatment, and the treatment suggested according to the application of the algorithm. After four weeks, the same questions were asked again to evaluate reliability (intra-and inter-observer) using the Kappa index. Results: The reliability of the treatment suggested by applying the algorithm was superior to the reliability of the surgeons' personal suggestion for treatment. When applying the upper cervical spine injury treatment algorithm, an agreement with the treatment actually performed was obtained in more than 89% of the cases. Conclusion: The system is safe and reliable for treating traumatic upper cervical spine injuries. The algorithm can be used to help surgeons in the decision between conservative versus surgical treatment of these injuries.
- Quality of life in adult intradural primary spinal tumors: 36-Item Short Form Health Survey correlation with McCormick and Aminoff-Logue scales(2013) GUIRADO, Vinicius M. P.; TARICCO, Mario A.; NOBRE, Moacyr R. C.; COUTO JUNIOR, Euro B.; RIBAS, Eduardo S. C.; MELUZZI, Alexandre; BROCK, Roger S.; DIAS, Mario R. Pena; RODRIGUES, Rodrigo; TEIXEIRA, Manoel J.Object. The most appropriate method to determine the quality of life of patients with intradural primary spinal tumors (IPSTs) is not still well established. Methods. Clinical data in 234 patients who underwent surgery for intradural spinal disease were collected prospectively. The 36-Item Short Form Health Survey (SF-36), a generic score scale, was administered to 148 patients with IPSTs to demonstrate if the survey can be used to effectively evaluate these patients. Forty-eight patients were excluded because they did not complete the protocol. The study was finally conducted with 100 patients (45 male and 55 female) with IPSTs, and the results were compared with those of 2 other scales: the McCormick scale and the Aminoff-Logue scale. Results. Construct validity was demonstrated by confirming the hypothesized relationship between the scores of the SF-36 and the McCormick scale (p = 0.003), the Aminoff-Logue gait subscale (p = 0.025), the Aminoff-Logue micturition subscale (p = 0.013), and the Aminoff-Logue defecation subscale (p = 0.004). Reliability was demonstrated for all 8 SF-36 domain scales and the Physical Component Summary and the Mental Component Summary of the SF-36, where in each the Cronbach alpha satisfied the Nunnally criterion of > 0.85. Conclusions. The authors' results demonstrated that SF-36 provides valid and reliable data for patients with IPSTs and that the survey can be used appropriately to evaluate these patients.
- Fatores prognósticos associados ao tratamento cirúrgico da mielorradiculopatia espondilótica cervical(2012) MELUZZI, Alexandre; TARICCO, Mário Augusto; BROCK, Roger Schimidth; DIAS, Mário Rubem Pena; NAKAGUAWA, Gilberto; GUIRADO, Vinícius Monteiro de Paula; TEIXEIRA, Manoel JacobsenOBJECTIVE: Identify the individual, social, environmental clinical factors and also imaging studies which correlate to the final result of neurological improvement in patients undergoing surgical treatment of cervical spondylotic myelopathy. METHODS: The clinical assessment was quantified by the deficit in JOA scale. We analyzed 200 cases of cervical myeloradiculopathy surgically treated in HC-FMUSP, from January 1993 to January 2007. The mean follow-up was 6 years and 8 months. The analysis was based on radiological criteria of instability by White and Kellgren scale. RESULTS: 80% had improved, 14% stabilized and 6% had worsened. The neurological deterioration was not associated with any clinical, environmental or imaging factor. The neurological improvement was directly proportional to the lower age at surgery, absence of co-morbidity, Hoffman sign, muscular atrophy, spinal cord hyperintensity on MRI, the shortest period of preoperative evolution, better preoperative neurological status and was inversely proportional to the AP diameter of the spinal canal and to multiple cord compressions. An association with smoking was observed. Over 70 years of age, evolution superior to 24 months, muscle atrophy, JOA score equal to or less than seven points and AP canal diameter less than or equal to 6mm were not associated with improvement.
article 2 Citação(ões) na Scopus Diaphragmatic pacing: unusual indication with successful application(2011) SARDENBERG, Rodrigo Afonso da Silva; SECAF, Liliana Bahia Pereira; PINOTTI, Adriana Cordeiro; TARICCO, Mario Augusto; BROCK, Roger Schmidt; YOUNES, Riad Naim- Survival score scales of patients operated with spinal metastases: retrospective application in a Brazilian population(2016) RIBAS, Eduardo Carvalhal; MATHIAS JUNIOR, Luis Roberto; GUIRADO, Vinicius Monteiro; BROCK, Roger Schmidt; TARICCO, Mario Augusto; DANIEL, Mauro Miguel; LOURENCO, Rafael Burgomeister; TEIXEIRA, Manoel JacobsenSpinal cord epidural metastasis (SEM) is a common complication of systemic cancer. Predicting these patient's survival is a key factor to select the proper treatment modality, but the three most used score scales to predict their survival (Tokuhashi revised score, Tomita score and Bauer modified score) were designed in single institutions and their reliability to predict correctly the patient's survival were first tested only in those specific populations. This prognostication issue is addressed in this article, evaluating retrospectively the survival of 17 patients with SEM from a Brazilian general hospital with these score scales. Our results show that the actual survival of those patients were worse than the predicted of all three score scales, suggesting that differences between the different populations might have affected their reliability and alert that their usage as a major factor to select the most appropriate treatment have to be done with caution.