Cervical Spondylotic Myelopathy (CSM) is a disabling condition arising from arthritic compression and consequent injury of the cervical spinal cord. Stratification of CSM severity has been useful t...

Study design: Systematic review. Objectives: Primary Spinal Intradural Tumours (PSITs) are rare pathologies that can significantly impact quality of life. This study aimed to review patient reported outcomes (PROs) in PSITs. Methods: A systematic search of Pubmed and Embase was performed to identify studies measuring PROs in adults with PSITs. PRO results were categorised as relating to Global, Physical, Social, or Mental health. Outcomes were summarised descriptively. Results: Following review of 2382 records, 11 studies were eligible for inclusion (737 patients). All studies assessed surgically treated patients. Schwannoma was the commonest pathology (n = 190). 7 studies measured PROs before and after surgery, the remainder assessed only post-operatively. For eight studies, PROs were obtained within 12 months of treatment. 21 PRO measurement tools were used across included studies, of which Euro-Qol-5D (n = 8) and the pain visual/numerical analogue scale (n = 5) were utilised most frequently. Although overall QoL is lower than healthy controls in PSITs, improvements following surgery were found in Extramedullary tumours (EMT) in overall physical, social, and mental health. Similar improvements were not significant across studies of Intramedullary tumours (IMT). Overall QoL and symptom burden was higher in IMT patients than in brain tumour patients. No studies evaluated the effect of chemotherapy or radiotherapy. Conclusion: Patients with PSITs suffer impaired PROs before and after surgery. This is particularly true for IMTs. PRO reporting in PSITs is hindered by a heterogeneity of reporting and varied measurement tools. This calls for the establishment of a standard set of PROs as well as the use of registries.

Introduction The response throughout the National Health Service (NHS) to the first wave of coronavirus disease 2019 (COVID-19) was substantial. With repeat winter waves of COVID-19 or other viral pathogens in the future being likely, we sought to review the impact of the response to the first wave on the delivery and training of neurosurgery in a large tertiary neurosurgical centre. Methods We performed a retrospective review over the three-month period of 8th March to 7th June 2020 as indicative of the peak of the pandemic in the UK. For referrals, our online referral portal was reviewed (ORION). For admissions and operations, electronic patient records were reviewed (EPIC systems). Trust wide update emails and policies were also reviewed. Results In response to the pandemic, neurosurgical service provision was severely restricted in the early days of the pandemic in the form of reduced beds, medical and nursing staff and theatres. This was rapidly realised to be unsustainable, and resources were slowly reopened although not to pre-COVID-19 levels. Although referrals did not substantially reduce, the number of elective and emergency admissions, length of stay, theatre efficiency and operative numbers (by pathology and grade of operating surgeon) did significantly reduce except for emergencies performed by consultants. If similar trainee operating numbers would have persisted, this would lead to a significant delay to completion of training. Conclusions All aspects of neurosurgical provision were detrimentally affected due to the rapid response to the first wave of COVID-19 in our institution. Such repeated reductions in acute services such as neurosurgery would be unsustainable. It is pertinent to re-visit these effects in preparation for future infection waves to better protect acute neurosurgical services.