Modified thoracolumbar injury classification and severity score (TLICS) and its clinical usefulness
Written by Dom Mahoney, MS
Appropriate classification of thoracolumbar spinal injuries is crucial for appropriate management of patients and communication between healthcare professionals. The thoracolumbar injury and classification score (TLICS) was designed in 2005 to stratify spinal injuries based on their morphology, neurological sequelae and the integrity of the posterior ligamentous complex. Eleven years later, authors of the above article suggest a modified approach to TLICS, which they report shows greater correlation to outcomes in their series. Both are summarised below.
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(DOI: 10.1177/0284185115580487)
Spinal Cord and Spinal Column Tumors: Principles and Practice
Written by Edoardo Agosti, MS
AUTHOR:
Curtis A. Dickman, Michael G. Fehlings, Ziya L. Gokaslan
EDITOR:
Thieme
PUBLICATION DATE:
March 2006
DESCRIPTION:
Spinal column and spinal cord tumors are relatively rare (approximately 3 to 4 times less common than intracranial tumors) with a variable incidence of 0.9 to 2.9 cases per 100,000 inhabitants each year. Despite the relatively low impact from an epidemiological point of view, they are certainly an important chapter in the field of neurosurgery both for diagnosis and for the management of patients.
Spinal Cord and Spinal Column Tumors: Principles and Practice is a text that fully addresses all aspects of tumours in this region, providing a detailed analysis of the anatomy, pathology, evaluation, diagnosis, and management techniques of spinal column and cord tumors.
From a therapeutic point of view, both neurosurgical and non-surgical treatments such as systemic and intrathecal chemotherapy, embolization techniques, external beam radiation
therapy, brachytherapy and stereotactic radiosurgery are addressed.
This book is a comprehensive text, lending insight into current techniques in managing these for all neurosurgeons and residents.
Eurospine 2017 - October 11 - 13, 2017
Written by Anatoli Dimitrov
The aims of EUROSPINE are to stimulate the exchange of knowledge and ideas in the field of research, prevention and treatment of spine diseases. There is also a strong drive to improve the collaboration between European spinal surgery centres. This year’s meeting promises to be of a high calibre, with presentations by world-renowned experts, discussions on the latest scientific developments, and opportunities to meet with colleagues and friends. It will be an event from which you can learn a great deal and enjoy yourself, finally taking something back home that you can put it in practice.
Impact of Tumor Histology on Resectability and Neurological Outcome in Primary Intramedullary Spinal Cord Tumors: A Single-Center Experience With 102 Patients
Written by Dom Mahoney, MS
Intramedullary spinal cord tumours have an estimated incidence of 1.1 cases in 100,000. Previously, the plane of dissection when surgically excising these lesions has been the key indicator for gauging extent of resection. Other articles have called into question the influence of histopathological characteristics on the definition of tumour boundary. The authors of this article report the results of a retrospective analysis determining the influence of tumour histology on resectability and neurological outcomes in cases of intramedullary spinal cord tumours. The 2016 WHO CNS classification emphasised the importance of genetic findings. This should be borne in mind when approaching results presented in articles in which this is not accounted for.
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Brainbook is a group of healthcare professional (neurosurgeons, trainees and nurses) working at The Royal London Hospital. An important feature distinguishing Brainbook from other similar groups is the aim to ease tension in patient’s families explaining what happens in a neurosurgical theatre. Furthermore, Brainbook hopes to make neurosurgical education accessible to all: contents are indeed totally free and concerning different topics. In this regard it is directed at medical students, residents, nurses and other healthcare professionals, as well has patients and their families.
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Spinal cord tumors present a significant treatment dilemma. This video summarizes clinical and surgical approaches to patients with intra- and extramedullary lesions.
Prof. Sciubba’s main area of interest is complex spine surgery, especially tumors and deformities. In his presentation he briefly explains the classification, differential diagnosis, management algorithm for intradural spinal cord tumors, as well as surgical outcomes, risks of postsurgical spinal deformities and need of instrumentation.
Use of intraoperative cell-salvage for autologous blood transfusions in metastatic spine tumour surgery: a systematic review
Written by Dom Mahoney, MS
Metastases make up the most significant group of tumours in the central nervous system in terms of incidence. Surgical resection of these lesions is often complicated by significant blood loss. Although allogenic blood product replacement is most frequently used to address this, the application of intraoperative cell salvage (IOCS) has been researched. Although the authors conclude that there is insufficient evidence to establish resolutely if IOCS is generally safe in cancer surgery, they did establish that the technique does not significantly increase the risk of tumour dissemination (a major concern in the use of IOCS). Critically, no studies on the use of IOCS in cases of spinal metastasis were included. However, the findings of the authors still provides valid justification for further investigation.
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Building neurosurgical capacity in low and middle income countries
Written by Edoardo Agosti, MS
Currently neurosurgery capacity in low- and middle-income countries is far from adequate due to staffing shortages, limited resources and poor bed space. There are about 33,000 neurosurgeons around the world, but more 91,000 will be needed to manage the 14 million additional patients who need neurosurgical treatment every day. This paper describes an ongoing collaboration between the Mulago Hospital Department of Neurosurgery (Kampala, Uganda) and Duke University Medical Center (Durham, NC, USA) as a replicable model to meet the needs of developing and developed countries.
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The World Federation of Neurosurgical Societies (WFNS) is a professional, scientific, non-governmental organization comprising 5 Continental Associations, 115 National Neurosurgical Societies, and represents some 30,000 neurosurgeons worldwide.
The World Federation of Neurosurgical Societies aspires to promote global improvement in neurosurgical care. The mission of the WFNS is to work together with member societies to improve worldwide neurosurgical care, training and research to benefit the patients.
The goals of the WFNS are deliberated and pursued through scientific, standing and ad-hoc committees and during the International Congress of Neurosurgery which takes place every four years.
The WFNS works to increase visibility and credibility of its activities among neurosurgeons, researchers, other health professionals, international professional organizations and the general public. This is accomplished through publications, surveys, campaigns, a website and cooperation with other medical and lay organization.
Resembling Istanbul’s harmonic blend of cultures, this year’s hosts aim to make “WFNS XVI. World Congress of Neurosurgery” a great opportunity to gather neurosurgeons from all around the world.
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An audit of the quality of care of traumatic brain injury at a busy regional hospital in South Africa
Written by Giorgio Saraceno, MS
WHO statistics demonstrate that TBI (traumatic brain injury) incidence is higher in low-middle income nations than those with a high income. Furthermore, TBI treatment is in the hands of many specialists and the patient passes through different clinical evaluations threatening to break the “chain of care” that is crucial for successful management. In some hospitals there are major violations or omissions of different protocols. A way to improve the acute care of patients suffering from TBI is to develop new protocols and strengthen those that already exist. However, the lack of resources is a problem that must be resolved to provide an environment encouraging more appropriate patient management.
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Bellwether Procedures for Monitoring and Planning Essential Surgical Care in Low- and Middle-Income Countries: Caesarean Delivery, Laparotomy, and Treatment of Open Fractures.
Written by Dom Mahoney, MS
Surgery is a heterogeneous field with varying groups of specialties involved, each associated with their own profile of patients and workload burden. With the introduction of the Global Surgery project, it is imperative to define surgical facilities that are most critical for patients to access so that efforts can be intelligently targeted and accurately assessed. The aim of this article was to propose ‘bellwether’ surgical procedures - a small number of operations which could be used to appreciate a trend in surgery as a whole. Just as a representative sample demonstrates patterns in a target population, trends regarding these bellwether procedures should exhibit patterns found across surgery.
The procedures were initially suggested by an expert panel, and then tested for their predictive capacity. This analysis determined that caesarean delivery, emergency laparotomy and open fracture fixation were all associated with highly statistically significant trends in provision of other surgical facilities.
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Moving forward together: The Lancet Commission on Global Surgery report and its implications for neurosurgical procedures.
Written by Edoardo Agosti, MS
With the establishment of the United Nations Millennium Development Goals (MDGs), a major progression has been made to identify the most prevalent public health challenges affecting low-middle income countries (LMICs) and the possible strategies for overcoming them. The priorities in surgical advancement have been stratified according to urgency ("must do", "should do" and "can do") based on a context-dependent framework.
In the case of neurosurgery and its global advancement, we must take into account the various issues in LMICs, such as low staffing, poor resources and lack of bed space. Initially, global neurosurgery has sought to make neurosurgical care accessible for common specific conditions such as pediatric hydrocephalus and intraventricular hemorrhage among premature infants.
However, significant gaps remain in the provision of neurosurgical care for the majority of surgically-amenable conditions. To address these problems, collaboration between neurosurgeons, health economists and public health officials is needed to find the most appropriate solution. In this way, the development of high-priority procedures and strategies that are relevant and achievable by various LMICs in the neurosurgical field can be ensured.
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Neurobehavioural Disability and Social Handicap Following Traumatic Brain Injury
Written by Edoardo Agosti, MS
This book focuses mainly on social and rehabilitative issues related to many forms of serious brain injury. While not addressing the aspects of neurosurgical practices of traumatic brain injuries, in my opinion this is an essential read for all neurosurgeons to develop an understanding of psychological and behavioral considerations. Neurobehavioural Disability and Social Handicap Following Traumatic Brain Injury offers the possibility to comprehend the pre- and post-operative problems of the patient, with a detailed assessment of the aspects related to social, behavioral, rehabilitative and family education.
Author:
Tom M. McMillan, Rodger Ll. Wood
Editor:
Psychology Press
Publication date:
17 feb 2017
7th Pannonian Symposium on Central Nervous System Injury
Written by Anatoli DimitrovAugust 30 – September 1, 2017
Pecs, Hungary
*25% Discount for EANS Members!*
Previous Pannonian CNS Injury Symposia sought to provide a unique environment for evaluation of translational research in traumatic brain injury.
Contemporary thought now appreciates that communication between basic scientists and clinicians is essential to improve the relevance and impact of advances as well as the quality of patient care and management - a major goal that the Pannonian symposia has embraced for more than 15 years.
There will be presentations from worldwide experts on brain injury research with a focus on pathobiology and applied clinical research. The application of this to patient care will also be discussed, ultimately leading to better treatments for our brain-injured population.