Prediction Accuracy of Common Prognostic Scoring Systems for Metastatic Spine Disease: Results of a Prospective International Multicentre Study of 1469 Patients.

Study Design: A prospective multicenter cohort study.

Objective: To assess the clinical accuracy of six commonly cited prognostic scoring systems for patients with spinal metastases.

Summary Of Background Data: There are presently several available methods for the estimation of prognosis in metastatic spinal disease, but none are universally accepted by surgeons for clinical use.

Metastatic Spine Tumor Epidemiology: Comparison of Trends in Surgery Across Two Decades and Three Continents.

Background: Indications for surgery for symptomatic spinal metastases have become better defined in recent years, and suitable outcome measures have been established against a changing backdrop of patient characteristics, tumor behavior, and oncologic treatments. Nonetheless, variations still exist in the local management of patients with spinal metastases. In this study, we aimed to review global trends and habits in the surgical treatment of symptomatic spinal metastases, and to examine how these have changed over the last 25 years.

Surgery and Radiotherapy for Symptomatic Spinal Metastases Is More Cost Effective Than Radiotherapy Alone: A Cost Utility Analysis in a U.K. Spinal Center.

Background: Surgery for symptomatic spinal metastases is effective at prolonging ambulation and life, but it can appear costly at first glance. We have studied the difference between the cost of surgery and reimbursement received, and the cost-effectiveness of surgery in a U.K.

Cost of Surgery for Symptomatic Spinal Metastases in the United Kingdom.

Background: Spinal metastases represent a significant health and economic burden. The average cost of surgical management varies between institutions and countries, partially a result of differences in health care system billing. This study assessed hospital costs from a single institute in the United Kingdom National Healthcare Service and identified patient factors associated with these costs.

Assessment of quality of life after surgery for spinal metastases: position statement of the Global Spine Tumour Study Group.

Objective: To review suitable measures of patient-assessed outcome of surgery for spinal metastases, and suggest the Health-Related Quality of Life measures that are useful and practical for this group of patients.

Methods: Surgery for metastatic spinal tumors is becoming more common, but the impact of surgery on the patient, as determined by patient-assessed outcome measures, is not well known. The authors of this article include members of the Global Spine Tumour Study Group: an international group of spinal surgeons who are studying the techniques and outcomes of surgery for spinal tumors.

Natural killer cell cytotoxicity in patients with recurrent herpes infections: diagnostic utility of a flow cytometric assay.

Background: Primary immune deficiencies of natural killer (NK) cells have been described in patients with a susceptibility to herpes infections.

Aims: To assess the diagnostic utility of measurement of NK cytotoxicity in patients with recurrent oral herpes infections.

Methods: A retrospective audit was carried out on results obtained over an 18-month period, from 28 NK cell cytotoxicity assays (24 patients; all with a history of recurrent oral herpes infections), and 24 control samples (three healthy donors).

Review of metastatic spine tumour classification and indications for surgery: the consensus statement of the Global Spine Tumour Study Group.

Choosing the right operation for metastatic spinal tumours is often difficult, and depends on many factors, including life expectancy and the balance of the risk of surgery against the likelihood of improving quality of life. Several prognostic scores have been devised to help the clinician decide the most appropriate course of action, but there still remains controversy over how to choose the best option; more often the decision is influenced by habit, belief and subjective experience. The purpose of this article is to review the present systems available for classifying spinal metastases, how these classifications can be used to help surgical planning, discuss surgical outcomes, and make suggestions for future research.

Outcome of 132 operations in 97 patients with chordomas of the craniocervical junction and upper cervical spine.

Objective: To study the outcomes of surgery for chordomas of the craniocervical junction and upper cervical spine as well as complication rates, survival, and associated adverse factors.

Methods: Retrospective review of patients (1982-2007) at 2 European centers who underwent transoral, transfacial, transmandibular, and anterior cervical approaches for excision of chordomas of the craniocervical junction and cervical spine. The chi test and Fisher exact test were used to determine significant adverse factors (P < .

Defining value in spine care.

Spinal disorders are extremely common, debilitating, and costly to the payer and to society as a whole. The rate and cost of various spinal treatments are increasing at an astonishing rate, but it is unclear whether the resulting quality of spinal care is improving. Rather than focusing solely on quality improvement measures or cost-saving measures, there is a recent emphasis on the value of health care.

Use of walking data in assessing operative results for cervical spondylotic myelopathy: long-term follow-up and comparison with controls.

Study Design: Retrospective case-control study.

Objective: To study the role of surgical decompression in cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Fifty patients who received surgery, and 34 patients with myelopathy who were offered surgery but declined, or were not medically fit for surgery.

Does spinal surgery improve the quality of life for those with extradural (spinal) osseous metastases? An international multicenter prospective observational study of 223 patients. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007.

Object: Opinions vary widely as to the role of surgery (from none to wide margin excision) in the management of spinal metastases. In this study the authors set out to ascertain if surgery improves the quality of remaining life in patients with spinal metastatic and tumor-related systemic disease.

Methods: The authors included 223 patients in this study who were referred by oncologists and physicians over a 2-year period.

Smear cytology in the intra-operative assessment of periodontoid pseudotumour of the craniocervical junction.

Objective: Periodontoid pseudotumours are lesions of presumed degenerative aetiology which typically occur in elderly patients with cervical myelopathy. The clinical and radiological differential diagnosis includes neoplastic and inflammatory lesions, and the exclusion of such lesions may be of value in the intra-operative management of the patient. This audit aimed to examine the value of intra-operative smear cytology in the management of this condition.

Accelerated apoptosis in SLE neutrophils cultured with anti-dsDNA antibody isolated from SLE patient serum: a pilot study.

Increased numbers of apoptotic neutrophils are found in SLE, related to disease activity and levels of anti-dsDNA antibody. The mechanism of increased apoptosis is not clear, but anti-dsDNA antibody has been shown to induce apoptosis in neutrophils from normal subjects and in certain cell lines. In this study, polyclonal anti-dsDNA antibody was isolated from the serum of a patient with active SLE, and was shown to substantially accelerate apoptosis in neutrophils from SLE patients as compared with neutrophils from healthy control or rheumatoid arthritis subjects.

Quality of life assessment using the Short Form-12 (SF-12) questionnaire in patients with cervical spondylotic myelopathy: comparison with SF-36.

Study Design: Clinical outcome study comparing the Short Form-36 (SF-36) and Short Form-12 (SF-12) assessment scales in patients with cervical spondylotic myelopathy (CSM).

Objectives: To compare the validity, reliability, and sensitivity to change of the SF-12 and SF-36 scales in CSM patients undergoing decompressive surgery.

Summary Of Background Data: The SF-36 is a generic Health Related Quality of Life (HRQoL) questionnaire, consisting of 36 questions that can be reported as a Physical (PCS) and Mental Component Summary (MCS).

Use of quantitative assessment scales in cervical spondylotic myelopathy--survey of clinician's attitudes.

Background: There is considerable uncertainty regarding the selection criteria of patients and timing of surgery for cervical spondylotic myelopathy (CSM). Attempts have been made to quantify CSM severity using various assessment scales to provide an adjunct to clinical decision-making. The aim of the present study was to determine, by means of a 7-item questionnaire the attitudes of clinicians regarding the importance of quantitative assessment scales in the management of CSM, their actual use in clinical practice and how current scales fall short of the ideal.

Distinctive effects of G-CSF, GM-CSF and TNFalpha on neutrophil apoptosis in systemic lupus erythematosus.

Objective: To investigate the influence of culture with G-CSF GM-CSF and TNFalpha on neutrophil apoptosis, comparing neutrophils from SLE patients with rheumatoid arthritis (RA) patients and healthy control subjects.

Methods: Neutrophils were isolated from SLE (n= 10), RA (n= 10) and healthy control subjects (n= 10), and cultured with two different concentrations of G-CSF, GM-CSF and TNFalpha. Proportion of apoptotic neutrophils at T=0, T=2hrs and T=24hrs was measured using FITC-labelled annexinV and flow cytometry.

Cervical spine chordoid meningioma. Case report.

Chordoid meningiomas are a rare but increasingly recognized subtype of meningioma. Although some cases have been associated with systemic symptoms, in many instances the clinical features are indistinguishable from those associated with other subtypes of meningioma. Given the prognostic significance of the diagnosis of chordoid meningioma, careful consideration should be given to the diagnosis during histological assessment.

Interleukin-10 receptor expression in systemic lupus erythematosus and rheumatoid arthritis.

Objective: We aimed to determine the expression of the interleukin-10 receptor (IL10R) on circulating leukocytes in SLE and rheumatoid arthritis, and correlate this with plasma IL-10 levels and disease activity.

Methods: Peripheral blood was sampled from 20 SLE patients, 14 rheumatoid arthritis patients, and 14 healthy controls. IL-10R expression was determined by immunofluorescence labelling and flow cytometric analysis.

A white clover nodulin gene, dd23b, encoding a cysteine cluster protein, is expressed in roots during the very early stages of interaction with Rhizobium leguminosarumbiovar trifolii and after treatment with chitolipooligosaccharide Nod factors.

An early nodulin cDNA, dd23b, was isolated from white clover root tissue by differential display RT-PCR. Its full-length sequence of 340 nucleotides encodes a predicted 72-amino-acid protein of molecular mass 8.3 kDa, with a polypeptide region containing cysteine pairs spaced in the manner of a cysteine cluster protein.