Spine Tumour Cancer

A proposed grading system of brain and spinal cavernomas

BACKGROUND: Most cavernomas in the central nervous system are characterized by a benign natural course. Progressive symptoms warrant surgical removal. In the literature, the factors affecting long-term postoperative outcome are not statistically well confirmed. OBJECTIVE: To perform a multifactorial analysis of risk factors on a large patient series and to use the results to propose a simple grading scale to predict outcome. METHODS: We studied 303 consecutive patients with cavernomas treated surgically at our department from 1980 to 2009. Follow-up assessment was performed on average 5.7 years postoperatively (range, 0.2-36 years). The main outcome measure was the patients’ condition at the last follow-up on Glasgow Outcome Scale. For statistical analysis, the outcome measure was dichotomized to favorable (Glasgow Outcome Scale 5) and unfavorable (Glasgow Outcome Scale 1-4). Binary logistic regression analysis was used to estimate the effect of age, sex, seizures, preexisting neurological deficits, hemorrhage, and size and location of cavernoma on long-term outcome. RESULTS: Infratentorial, basal ganglia, or spinal location and preexisting neurological deficit were the only independent risk factors for unfavorable outcome, with relative risks of 2.7 (P = .008) and 3.2 (P = .002), respectively. We formulated a grading system based on a score of 1 to 3. When applied to our series, the proposed grading system strongly correlated with outcome (P < .001, Pearson chi test). The risk for long-term unfavorable outcome was 13%, 22%, and 55% for grades 1 through 3, respectively. CONCLUSION: The proposed grading system showed a convincing correlation with postoperative outcome in surgically treated cavernoma patients Keywords : Adolescent,Adult,Aged,Aged,80 and over,analysis,Basal Ganglia,Brain,Brain Neoplasms,Central Nervous System,Child,Child,Preschool,classification,Female,Glasgow Outcome Scale,Hemangioma,Cavernous,Central Nervous System,Hemorrhage,Humans,Infant,Male,methods,Middle Aged,Neoplasm Grading,Nervous System,Neurosurgery,pathology,Patients,Regression Analysis,Risk,Risk Factors,Seizures,Spinal Cord Neoplasms,surgery,Treatment Outcome,Universities,Young Adult,, Proposed,Grading,System,Brain, how much do cortisone injections cost uk

Date of Publication : 2011 Oct

Authors : Kivelev J;Laakso A;Niemela M;Hernesniemi J;

Organisation : Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland. juri.kivelev@hus.fi

Journal of Publication : Neurosurgery

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21508872

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2022-06-10

Fabulous service Fabulous service. Mr Akmal truly cares about his patients and how he can improve their quality of life. I would recommend him to anyone with any kind of spinal issue.

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2022-06-08

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2022-06-06

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Extraordinary Care My 81 year old mother who has retired in Ghana was suffering from severe lower back pain so a local surgeon put her through discectomy with hardware (spine screws). The procedure was essentially botched, with one screw breaching her spinal canal resulting in extreme pain; unable to walk, pins and needles and numbness in the left leg. The hardware subsequently had become infected and loosened as a result. Her life after this surgery was the worse she has ever experienced in all her life. She had no doubt that she was eventually to die from the infection and pain. Fortunately, through diligent search, we found Mr Akmal and his team at The UK Spine Centre. She had a zoom consultation and with a ready MRI and CT scan, Mr Akmal knew exactly how to have her back to fitness and a better quality of life. She travelled to England on 26 March 2022 and had the surgery on 11 April 2022. It was a day-case. It lasted no more than 1 hour 30 minutes. She was on my feet within 2 hours pain free - still pain free 5 weeks on! To her this is simply a miracle ! She is grateful to Jehovah God for Mr Akmal and his team - thoroughly professional bunch at the top of their game. No one deserves to suffer the pain she experienced for two years. She seriously recommends Mr Akmal and his team for anything SPINE!

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2022-05-18

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2022-04-22

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2022-04-02

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2022-03-22

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2022-03-17

Great service and painless procedure Great service and painless procedure. Definitely alleviated the pain

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