Perioperative visual loss and consent for adult spine surgery: a national survey of the practice amongst spine surgeons and anaesthetists.

Background: Perioperative Visual Loss (POVL) is a devastating complication for patients undergoing spine surgery. Consent process for POVL amongst spine surgeons and anaesthetist remains variable. The aim of this study is to evaluate their practice and views about it.

Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension.

Background: We aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG).

Methods: A 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives. The scope and purpose of the guideline were agreed by the SIG by consensus.

Foramen Magnum Decompression for Chiari Malformation Type 1: Is There a Superior Surgical Technique?

Background: Foramen magnum decompression is a common operation used to treat Chiari malformation. There are different surgical techniques; however, some are anecdotally more effective than others. Our aim was to determine whether there is a superior technique in relation to revision rates, presence of persistent postoperative headache and nausea, and syrinx reduction.

Survey of healthcare professionals' knowledge, attitudes and practices regarding spontaneous intracranial hypotension.

Objective: To assess the knowledge, attitudes and practices of healthcare professionals regarding the diagnosis and management of spontaneous intracranial hypotension (SIH).

Methods: We performed a cross-sectional, web-based survey of multiple healthcare professional groups in the UK from June to August 2021. There were 227 respondents to the survey, including 62 general practitioners, 39 emergency medicine physicians, 38 neurologists, 35 radiologists, 20 neurosurgeons, 18 anaesthetists and 15 headache nurse specialists.

Foramen magnum decompression for Chiari malformation type I - UK surgical practice.

Symptomatic Chiari 1 malformation (CM1) is a common condition in Neurosurgery. Surgery involves hindbrain decompression and restoration of CSF flow through different surgical approaches. No Class 1 evidence exists to suggest the superiority of any of the surgical techniques.

Retrieval analysis of an explanted Mobi-C cervical disc replacement: A case study.

Ex vivo analysis of artificial discs is essential to better understand their ability to replace degenerated intervertebral discs. The Mobi-C differs from some other contemporary disc designs in that it has a mobile polyethylene insert that is sandwiched between superior and inferior cobalt chromium endplates. While some studies claim the Mobi-C to have restored normal cervical spinal biomechanics, others have noted high levels of migration.

Surgical decompressions for cauda equina syndrome during COVID-19.

Background: The novel coronarvirus disease (COVID-19) has had a major impact on provision of spinal neurosurgery across the world, especially in the UK, with a significant fall in operating and patient volumes, and elective clinical activities. It is unclear whether the pandemic has affected the volume of urgent spinal procedures in the UK, especially surgical decompressions for cauda equina syndrome (CES).

Methods: Therefore, we conducted a retrospective analysis of theatre records and electronic operation notes at our institution to identify all procedures performed for CES before (December 2019 to February 2020) and during (March 2020 to May 2020) the COVID-19 pandemic.

Spinal cord compression due to nucleus migration from Mobi-C total disc replacement.

Cervical disc replacement is an alternative option to an anterior cervical discectomy and fusion for cervical spine degenerative disease. We present the first reported case of a progressively worsening symptomatic spinal cord compression secondary to migration of the nucleus from a Mobi-C total disc replacement.

Potential wrong-level surgery for an intra-dural thoracic spinal tumour: the importance of optimum imaging and consistency in the direction in which the level is determined.

The spectre of wrong-level surgery has many a spinal surgeon double-checking the spinal level at which an operation is being carried out especially in the thoracic spine, in the absence of abnormal-looking vertebrae which could help to identify the intended level. Getting the level wrong is easily done if there is an unusual number of vertebrae or if the direction of the count digresses from the imaging available.

Cauda equina syndrome secondary to intradural renal cell carcinoma metastasis haemorrhage.

Intradural renal cell carcinoma (RCC) metastasis is rare. We report a case of an 81-year-old female presenting with acute cauda equina syndrome (CES), secondary to intradural RCC metastasis haemorrhage. To our knowledge this is the first case of CES secondary to acute haemorrhage within an intradural RCC metastasis.

Emergency neurosurgical referrals in the North East of England - trends over four years 2008-2011.

Aims: On-call referrals are a considerable part of the neurosurgical workload. Many neurosurgical centres in the UK have now adopted the practice of maintenance of electronic databases to keep records of on-call activity. We analysed the neurosurgical on-call referrals database maintained at the Newcastle General Hospital (NGH)/Royal Victoria Infirmary (RVI) to assess any trends in the nature of referrals.