Introduction. Spinal conditions commonly cause pain and disability. Various non-operative treatments including acupuncture are practiced for these conditions. Aim. To evaluate the effectiveness of acupuncture in management of common spinal conditions. Methodology. Between Jan 2011 and Feb 2013, 151 patients who received manual acupuncture in a hospital environment were assessed for pain improvement on Numerical-rating- scale (NRS) of 0–10, overall improvement with Core Outcome Measure Index (COMI) and for satisfaction with the care. Results. 110 had low back pain with and or radicular symptoms, 33 had neck pain and or radicular symptoms, 05 had thoracic and 04 multilevel symptoms. Average number of session given were 3.98 (range 2 to 8). Minimum and maximum reported pain improved statistically from 4.17 to 2.94 (Df 1.2, p = 0.00) and 8.00 to 6.03 (Df 1.9, p = 0.00) respectively but were below Minimum Clinically Important Difference (MCID) of 2. COMI improved statistically from 6.39(SD1.6) to 5.37 (SD 1.9) (Df 1.02, p = 0.00) that was below group MCID of COMI of 2.6. Seventy-five required further treatment, 49 were discharged and 11 patient did not complete the treatment. Discussion. Acupuncture is an NICE recommended established adjuvant treatment for treating common spinal conditions. This study demonstrates it to a be a safe technique with high patient satisfaction with statistically significant improvement in outcome measures that are below MCID of improvement raising questions on its cost effectiveness in routine clinical practice

Sacro-coccygeal chordomas pose a difficult diagnostic and therapeutic problem due to late presentation, large size, soft-tisue extension, difficulties in obtaining adequate resection margins, higher local recurrence rate and uncertain effectiveness of adjuvant treatment. We present a series of 21 patients of sacral chordomas obtained from Scottish Bone Tumour Registry to analyse predictors of local control and survival. The clinical and morphologic features, type of treatment and follow-up of 21 consecutive patients with sacral chordoma were retrospectively reviewed and analysed. The data were obtained from Scottish Bone Tumour Registry. The average age at time of the biopsy was 59 years (range, 12 to 82 years): twelve patients were male and nine were female. Pain was the presenting symptom in all patients. Two had intralesional (both recurred), 9 marginal (4 recurred) and 3 wide resections (1 recurred). Fifteen of the twenty-one patients were treated with adjuvant radiation therapy. In seven patients, the chordoma was inoperable and all but one were treated with adjuvant radiotherapy. Local recurrence and metastases occurred in 7 (50%) and 5 (23.8%) patients. The 5-year and 10-year survival were 38% and 14.2%, respectively. Excision of the lesion combined with adjuvant radiation therapy provided satisfactory results. Local recurrence presents a major problem in the management of sacral chordomas (50%). Intralesional resection should be avoided as it is associated with 100% local recurrence in our series

This review provides a concise outline of the advances made in the care of patients and to the quality of life after a traumatic spinal cord injury (SCI) over the last century. Despite these improvements reversal of the neurological injury is not yet possible. Instead, current treatment is limited to providing symptomatic relief, avoiding secondary insults and preventing additional sequelae. However, with an ever-advancing technology and deeper understanding of the damaged spinal cord, this appears increasingly conceivable. A brief synopsis of the most prominent challenges facing both clinicians and research scientists in developing functional treatments for a progressively complex injury are presented. Moreover, the multiple mechanisms by which damage propagates many months after the original injury requires a multifaceted approach to ameliorate the human spinal cord. We discuss potential methods to protect the spinal cord from damage, and to manipulate the inherent inhibition of the spinal cord to regeneration and repair. Although acute and chronic SCI share common final pathways resulting in cell death and neurological deficits, the underlying putative mechanisms of chronic SCI and the treatments are not covered in this review.

Aims

To evaluate the perioperative complications associated with total en bloc spondylectomy (TES) in patients with spinal tumours, based on the extent and level of tumour resection.

Aims

This study aimed to evaluate the incidence and prognosis of patients with spinal metastasis as the initial manifestation of malignancy (SM-IMM).