A 30-year-old pregnant female presented to the emergency department with labor pain in her 39th week of pregnancy. Cesarean section under spinal anesthesia was the chosen route of delivery for this patient due to previous cesarean section in her first pregnancy. The delivery itself was uneventful but seven hours after the surgery, bilateral swelling of parotid glands were noted. Rehydration therapy and a single dose of hydrocortisone (100mg IV route) were administered, and swellings were completely resolved on postoperative day 2. This is one of the rare cases of anesthesia mumps after spinal anesthesia, and we think rehydration therapy and the single dose corticosteroid may prove useful in these cases.

Study Design: Systematic Review and Meta-Analysis. Objectives: Degenerative cervical myelopathy (DCM), the leading cause of spinal cord injury globally, may clinically manifest with hand numbness and tingling, loss of hand dexterity and impaired balance and gait. Biomarkers have been identified as disease indicators with recent studies exploring the role of structural and inflammatory biomarkers in diagnostic and treatment outcome prediction. The review aims to identify relevant cerebrospinal fluid (CSF) and blood-based biomarkers associated with DCM diagnosis and prognostication. Methods: The systematic review was conducted as per PRISMA guidelines. A comprehensive search strategy was devised to identify articles evaluating biomarkers in DCM and comparative control cohorts. The studies were screened by two independent reviewers and discrepancies resolved by a third author. Study characteristics were recorded, and data synthesis was performed to allow for pooled analyses. The quality of included studies and risk of bias were assessed using the QUADAS-2 tool. Results: A total of 17 studies incorporating 699 individuals with DCM and 475 controls were included. 9 studies evaluated CSF biomarkers while 6 and 2 studies reviewed blood-based and CSF-to-serum quotients, respectively. Pooled analyses revealed significantly higher levels of NF-L and IL-6, albumin-Q, IgA-Q, and IgG-Q in the DCM cohort as compared to the control group. Conclusion: This systematic review highlights the structural and inflammatory biomarkers that can be potentially used as substitutes for diagnosing and prognosticating outcomes for DCM. The findings further suggest the need for larger prospective studies to assess the clinical relevance of these biomarkers in DCM management.

Background: The spinal instability neoplastic score (SINS) provides a standardized assessment of spinal stability in patients with metastatic spine disease. Although intended to assist clinical decision-making, the relationships between SINS and patient-centered measures, such as pain intensity, functional status, and health-related quality of life (HRQoL), remain undefined. Methods: This systematic review followed PRISMA guidelines. A comprehensive literature search was performed across PubMed, Scopus, Embase, and Web of Science databases using keywords related to SINS and spinal metastases. Studies assessing the relationships between SINS and pain intensity scores, functional status, and HRQoL were included. Data on study characteristics, type of interventions, and patient-centered measures were extracted. Risk of bias was assessed using the Newcastle-Ottawa Scale. A meta-analysis was not feasible due to significant treatment, outcome, and population heterogeneity. Results: Thirteen studies (n = 1823; mean age 63.0 ± 12.5 years) were included. Five of six studies reported a significant association between higher baseline SINS scores and pain intensity, most commonly using the Visual Analog Scale and Numeric Rating, while 1 of 2 studies identified a predictive value of SINS for posttreatment pain. Nine studies evaluated peri-interventional functional status using 6 different tools; significant correlations with baseline SINS were identified for MD Anderson Symptom Inventory and Spine Oncology Study Group Outcomes Questionnaire 2.0, while no relationships were identified for the Barthel Index, Eastern Cooperative Oncology Group score, or Frankel scale. Further, stable postradiotherapy SINS was associated a higher baseline Karnofsky Performance Status (KPS). Three studies assessed HRQoL using either the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, the 36-Item Short Form Survey, or the EuroQol Five-Dimension Scale; 2 of these studies reported that higher SINS values were associated with lower baseline physical functioning. Of 13 studies, 12 were of moderate methodological quality. Conclusions: SINS demonstrated correlations with peri-interventional pain intensity, functional status, and HRQoL. Pretreatment correlations were generally more consistent. However, in radiotherapy-treated cohorts, stable posttreatment SINS was associated with higher baseline KPS, suggesting a potential predictive relationship between these measures.