Álvaro Dowling
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View article: Computational GWAS Meta Meta Analysis Revealing Cross Talk Between Cannabis CNR1 and DRD2 Receptors Optimizing Long-Term Outcomes for Cannabis Use Disorder (CUD) By Enhancing Dopamine Homeostasis Promoting High-Quality Cannabis Medicinals
Computational GWAS Meta Meta Analysis Revealing Cross Talk Between Cannabis CNR1 and DRD2 Receptors Optimizing Long-Term Outcomes for Cannabis Use Disorder (CUD) By Enhancing Dopamine Homeostasis Promoting High-Quality Cannabis Medicinals Open
This paper presents a shared perspective from scientists and clinicians seeking to harness the therapeutic potential of cannabis while addressing Cannabis Use Disorder (CUD) through reproducible scientific findings. Acute cannabis use may …
View article: GLP-1 Agonists Can Be Heaven or Hell Dependent Upon Dopaminergic Genetic/Epigenetic Antecedents
GLP-1 Agonists Can Be Heaven or Hell Dependent Upon Dopaminergic Genetic/Epigenetic Antecedents Open
Background: GLP‑1 receptor agonists (GLP‑1RAs) are effective for type 2 diabetes and obesity and engage central stress and reward pathways (HPA axis; mesolimbic dopamine). Psychiatric signals have been reported in some settings. Objective …
View article: Endoscopic transfacet Decompression for Severe Lumbar Spinal Stenosis: A Technical Note, Illustrative Clinical Series, and Surgeon Survey Regarding Post-Decompression Instability
Endoscopic transfacet Decompression for Severe Lumbar Spinal Stenosis: A Technical Note, Illustrative Clinical Series, and Surgeon Survey Regarding Post-Decompression Instability Open
Background: Lumbar spinal stenosis (LSS) remains a predominant cause of debilitating back and leg pain, affecting many aging populations. Traditional decompression surgeries can be invasive and pose significant risks and recovery time. Thi…
View article: Transient C5 Palsy After Full‐Endoscopic Posterior Cervical Foraminotomy
Transient C5 Palsy After Full‐Endoscopic Posterior Cervical Foraminotomy Open
Introduction Postoperative C5 paralysis is defined as new‐onset and/or progressive muscle weakness with mild or no sensory disturbances occurring as a result of probable neuropraxia of the cervical root due to injury during surgery. Case R…
View article: Review of: "Endoscopic Posterior Cervical Laminoforaminotomy: Minimally Invasive Relief for Cervical Radiculopathy"
Review of: "Endoscopic Posterior Cervical Laminoforaminotomy: Minimally Invasive Relief for Cervical Radiculopathy" Open
View article: Insights From the ISASS Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery | Part 1: Polytomous Rasch Analysis of Surgeon Endorsement of Endoscopic Discectomy/Foraminotomy, Interbody Fusion, and Importance of Patient Feedback During Surgery
Insights From the ISASS Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery | Part 1: Polytomous Rasch Analysis of Surgeon Endorsement of Endoscopic Discectomy/Foraminotomy, Interbody Fusion, and Importance of Patient Feedback During Surgery Open
Level 2 (inferential) and 3 (observational) evidence because Rasch analysis provides statistical validation of instruments rather than direct clinical outcomes.
View article: Polytomous Rasch Analyses of Surgeons’ Decision-Making on Choice of Procedure in Endoscopic Lumbar Spinal Stenosis Decompression Surgeries
Polytomous Rasch Analyses of Surgeons’ Decision-Making on Choice of Procedure in Endoscopic Lumbar Spinal Stenosis Decompression Surgeries Open
Surgeon decision-making in selecting patients for endoscopic surgery for lumbar spinal stenosis is multifaceted. While the framework of clinical guidelines remains paramount, on-the-ground experience-based factors significantly influence s…
View article: Comparative Analysis of Learning Curve, Complexity, Psychological Stress, and Work Relative Value Units for CPT 62380 Endoscopic Lumbar Spinal Decompression vs Traditional Lumbar Spine Surgeries: A Paired Rasch Survey Study
Comparative Analysis of Learning Curve, Complexity, Psychological Stress, and Work Relative Value Units for CPT 62380 Endoscopic Lumbar Spinal Decompression vs Traditional Lumbar Spine Surgeries: A Paired Rasch Survey Study Open
Level 3.
View article: EFFICACY AND SAFETY OF STEM CELLS IN STANDALONE LUMBAR INTERBODY FUSION FOR RECURRENT DISC HERNIATIONS
EFFICACY AND SAFETY OF STEM CELLS IN STANDALONE LUMBAR INTERBODY FUSION FOR RECURRENT DISC HERNIATIONS Open
Objective: This study aimed to evaluate the therapeutic effectiveness and safety of allogeneic stem cell injections in the intervertebral discs of patients with recurrent disc herniations. Methods: An observational cohort study involved 75…
View article: Randomized Clinical Trials and Observational Tribulations: Providing Clinical Evidence for Personalized Surgical Pain Management Care Models
Randomized Clinical Trials and Observational Tribulations: Providing Clinical Evidence for Personalized Surgical Pain Management Care Models Open
Proving clinical superiority of personalized care models in interventional and surgical pain management is challenging. The apparent difficulties may arise from the inability to standardize complex surgical procedures that often involve mu…
View article: Durotomy- and Irrigation-Related Serious Adverse Events During Spinal Endoscopy: Illustrative Case Series and International Surgeon Survey
Durotomy- and Irrigation-Related Serious Adverse Events During Spinal Endoscopy: Illustrative Case Series and International Surgeon Survey Open
Patients should be educated preoperatively about the risk of irrigated spinal endoscopy. Although rare, intracranial blood, hydrocephalus, headaches, neck pain, seizures, and more severe complications, including life-threatening autonomic …
View article: The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States
The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States Open
Personalized care models are dominating modern medicine. These models are rooted in teaching future physicians the skill set to keep up with innovation. In orthopedic surgery and neurosurgery, education is increasingly influenced by augmen…
View article: Personalized Interventional Surgery of the Lumbar Spine: A Perspective on Minimally Invasive and Neuroendoscopic Decompression for Spinal Stenosis
Personalized Interventional Surgery of the Lumbar Spine: A Perspective on Minimally Invasive and Neuroendoscopic Decompression for Spinal Stenosis Open
Pain generator-based lumbar spinal decompression surgery is the backbone of modern spine care. In contrast to traditional image-based medical necessity criteria for spinal surgery, assessing the severity of neural element encroachment, ins…
View article: Spine Surgery in the Chilean Public Health System
Spine Surgery in the Chilean Public Health System Open
Chile is a country with an area of 756,102 km2.[1][1] It spans a distance of 4270 km (2653 miles) of coastline from north to south, which creates problems in delivering sophisticated health care in rural areas. It is the 38th largest count…
View article: Joint International SILACO, SICCMII, ISASS Symposium as a Model for a Collaborative Framework to Create Literature on Advances in Spine Surgery, Patient Care, and Policy
Joint International SILACO, SICCMII, ISASS Symposium as a Model for a Collaborative Framework to Create Literature on Advances in Spine Surgery, Patient Care, and Policy Open
International collaborations can be the key to overcoming innovation implementation hurdles. The authors report on a joint symposium between the International Society For The Advancement of Spine Surgery (ISASS) and La Sociedad Iberolatino…
View article: Breaking through the glass ceiling effect of high-grade clinical evidence creation in orthopaedics & trauma
Breaking through the glass ceiling effect of high-grade clinical evidence creation in orthopaedics & trauma Open
Introduction: Randomization protocols in clinical studies of common orthopedic problems and traumatic injuries are challenging to orchestrate. The lack of high-grade clinical evidence from prospective randomized, double-blinded study desig…
View article: A Proposed Personalized Spine Care Protocol (SpineScreen) to Treat Visualized Pain Generators: An Illustrative Study Comparing Clinical Outcomes and Postoperative Reoperations between Targeted Endoscopic Lumbar Decompression Surgery, Minimally Invasive TLIF and Open Laminectomy
A Proposed Personalized Spine Care Protocol (SpineScreen) to Treat Visualized Pain Generators: An Illustrative Study Comparing Clinical Outcomes and Postoperative Reoperations between Targeted Endoscopic Lumbar Decompression Surgery, Minimally Invasive TLIF and Open Laminectomy Open
Background: Endoscopically visualized spine surgery has become an essential tool that aids in identifying and treating anatomical spine pathologies that are not well demonstrated by traditional advanced imaging, including MRI. These pathol…
View article: Differential Agnostic Effect Size Analysis of Lumbar Stenosis Surgeries
Differential Agnostic Effect Size Analysis of Lumbar Stenosis Surgeries Open
STUDY DESIGN: A meta-analysis of 89 randomized prospective, prospective, and retrospective studies on spinal endoscopic surgery outcomes. OBJECTIVE: The study aimed to provide familiar Oswestry Disability Index (ODI), visual analog scale (…
View article: LUMBAR ENDOSCOPIC DISCECTOMY IN OBESE PATIENTS
LUMBAR ENDOSCOPIC DISCECTOMY IN OBESE PATIENTS Open
Objective The aim of this study was to evaluate the clinical and functional results of endoscopic lumbar discectomy in obese patients. Methods We selected 56 patients with lumbar disc hernia refractory to clinical treatment that underwent …
View article: Dural Tears During Lumbar Spinal Endoscopy: Surgeon Skill, Training, Incidence, Risk Factors, and Management
Dural Tears During Lumbar Spinal Endoscopy: Surgeon Skill, Training, Incidence, Risk Factors, and Management Open
3.
View article: SURGERY FOR LUMBAR DISC HERNIATION: OPEN X MINIMALLY INVASIVE TECHNIQUE
SURGERY FOR LUMBAR DISC HERNIATION: OPEN X MINIMALLY INVASIVE TECHNIQUE Open
Objective: In Brazil, there are no studies comparing endoscopic treatment of lumbar disc herniation with the conventional open technique in SUS (Unified Health System) with regard to hospitalization time and complications occurring within …
View article: SURGERY FOR LUMBAR DISC HERNIATION: OPEN X MINIMALLY INVASIVE TECHNIQUE
SURGERY FOR LUMBAR DISC HERNIATION: OPEN X MINIMALLY INVASIVE TECHNIQUE Open
Objective: In Brazil, there are no studies comparing endoscopic treatment of lumbar disc herniation with the conventional open technique in SUS (Unified Health System) with regard to hospitalization time and complications occurring within …
View article: Endoscopic Transforaminal Lumbar Interbody Fusion With a Single Oblique PEEK Cage and Posterior Supplemental Fixation
Endoscopic Transforaminal Lumbar Interbody Fusion With a Single Oblique PEEK Cage and Posterior Supplemental Fixation Open
Feasibility study.
View article: Transforaminal Endoscopic Lumbar Discectomy: Clinical Outcomes and Complications.
Transforaminal Endoscopic Lumbar Discectomy: Clinical Outcomes and Complications. Open
Objective To evaluate the clinical and functional results of transforaminal endoscopic lumbar discectomy. Materials and Methods From August 2015 to January 2017, 101 patients with lumbar disc hernia refractory to clinical tre…
View article: Discectomia endoscópica transforaminal lombar: Resultados clínicos e complicações
Discectomia endoscópica transforaminal lombar: Resultados clínicos e complicações Open
Resumo Objetivo Avaliar os resultados clínicos e funcionais da discectomia endoscópica transforaminal lombar. Materiais e Métodos De agosto de 2015 a janeiro de 2017, 101 pacientes portadores de hérnia de disco lombar refratária ao tratame…
View article: Patient selection protocols for endoscopic transforaminal, interlaminar, and translaminar decompression of lumbar spinal stenosis
Patient selection protocols for endoscopic transforaminal, interlaminar, and translaminar decompression of lumbar spinal stenosis Open
This study suggests that in the hands of skilled endoscopic spines surgeon use of an image-based stenosis location protocol may contribute to obtaining Excellent and Good clinical outcomes in a high percentage (93%) of patien…
View article: Surgeon motivation, and obstacles to the implementation of minimally invasive spinal surgery techniques
Surgeon motivation, and obstacles to the implementation of minimally invasive spinal surgery techniques Open
The rate of implementation of MISST reported by spine surgeons was found to be high but impeded by the high cost of equipment and disposables. The primary motivators for spine surgeons' desire to implement were personal interest and patien…
View article: Surgeon training and clinical implementation of spinal endoscopy in routine practice: results of a global survey
Surgeon training and clinical implementation of spinal endoscopy in routine practice: results of a global survey Open
The majority of spine surgeons reported more than half of their cases employing MISST at a high skill level. Very few MISST surgeons are fellowship trained but attend workshops and various meetings suggesting that many of them are self-tho…
View article: Regional variations in acceptance, and utilization of minimally invasive spinal surgery techniques among spine surgeons: results of a global survey
Regional variations in acceptance, and utilization of minimally invasive spinal surgery techniques among spine surgeons: results of a global survey Open
The rate of implementation of MISST into day-to-day clinical practice reported by spine surgeons was universally higher than the perceived acceptance rates of MISST into the mainstream by their peers in their practice area. The survey sugg…
View article: LUMBAR ENDOSCOPIC DISCECTOMY IN OBESE PATIENTS
LUMBAR ENDOSCOPIC DISCECTOMY IN OBESE PATIENTS Open
Objective The aim of this study was to evaluate the clinical and functional results of endoscopic lumbar discectomy in obese patients. Methods We selected 56 patients with lumbar disc hernia refractory to clinical treatment that underwent …