Marcin Czyz

• MD, PhD
• Consultant Spine Neurosurgeron and Honorary Associate Clinical Professor at University Hospitals Birmingham NHS Foundation Trust

Purpose Cauda Equina Syndrome (CES) is a rare surgical emergency. The implications for loss of quality of life through delayed management are high, though no clinical symptom is pathognomonic in its diagnosis. We describe how machine learning based algorithms can be used in triaging patients with suspected CES (CES-S). Methods Data of 499 patients...

Aim To provide an insight into our current understanding in the genomics of spinal chordomas with regards to pathogenesis and treatments. Method Three terms – ‘spine’, ‘chordoma’ and ‘genomics’ were searched on PubMed and Embase. Papers published until 2022 were included. Exclusion criteria were conference s, letters, and duplicates. The final res...

The management of spinal metastases focuses on reducing symptoms and protecting the spinal cord, historically involving extracorporeal radiotherapy alone. The use of separation surgery techniques alongside high-dose radiotherapy to treat spinal metastases is a novel concept and has changed the treatment paradigm. Additionally, titanium implants hav...

Select spinal tumors can be treated with en bloc spondylectomy (EBS) but the surgical complexity and relatively low frequency of eligible tumors render EBS an uncommon procedure. The expanded surgical access encompasses acceptance of relatively high morbidity as a trade-off against improved oncological results and survival. EBS durations can be lon...

The advent of the human genome project has offered new insights into the aetiology of rare tumours along with the potential for development of new diagnostic and therapeutic targets. Chondrosarcoma is one of the most common primary tumours of the spine, accounting for approximately 20-27% of primary bone malignancies [1]. Thoracic spine is thought...

Introduction: The management of spinal metastases focuses on reducing symptoms and protecting the spinal cord and has historically involved extracorporeal radiotherapy alone. The use of separation surgery techniques alongside stereotactic radiotherapy (SBRT) to treat spinal metastases has increased. There has been an ongoing debate about the choice...

En bloc resection in the spine is performed for both primary and metastatic bone lesions and has been proven to lengthen disease-free survival and decrease the likelihood of local recurrence. It is a complex procedure, which requires a thorough multi-disciplinary approach. This article will discuss the role of the radiologist in characterizing the...

Introduction Intradural spinal tumours are relatively uncommon tumours of the central nervous system. In this study, we sought to assess our current practice and determine the factors which affect the surgical outcomes of intradural spinal tumour resection. Methods All consecutive patients who underwent surgical resection of intradural spinal tumou...

Background: The literature on total en bloc spondylectomy (TES) of bone tumors of the lumbar spine is sparse and heterogeneous. Therefore, the aim was to systematically pool the data from the published studies to quantitatively summarize the morbidity and mortality and to identify factors associated with favorable outcomes and complications. Meth...

En-bloc resection of spinal tumours is a complex procedure with significant morbidity and mortality. The extensive resection leaves a large soft tissue and osseous defect requiring reconstruction. Following en-bloc resection, there may be complications relating to the both the removal of the tumour and the subsequent reconstruction. This paper outl...

Background Identifying patients at risk of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (aSAH) remains challenging. This study aimed to evaluate the concentration of serum biomarkers along with cerebral autoregulation impairment on DCI. Methods 55 patients suffering from aSAH were enrolled in the study. Serum S100 prot...

Introduction: Tumours of the odontoid peg are rare but can potentially cause significant morbidity and mortality. Methods: Aretrospective review of oncology and radiology database of tertiary orthopaedic oncology centre for all lesions affecting the odontoid peg over the last 12 years was performed. Results: We identified a total of 15 tumours invo...

Giant cell tumour (GCT) of the spine is a benign aggressive tumour with high recurrence rates. Patients can be asymptomatic due to the slow growth rate and present with localized pain or neurological dysfunction. Current management strategies include intralesional curettage, total en-bloc resection (TER) and denosumab therapy. Treatment strategies...

Endoscopic cystocysternostomy or cystoventriculostomy is the treatment of choice in patients with symptomatic intracranial arachnoid cysts. There are no objective diagnostic tests for reliable intraoperative evaluation of the effectiveness of performed stomies. The aim of this prospective open-label study is to demonstrate for the first time the us...

COVID-19 pandemic presents significant challenges in delivering safe and efficient patient care, especially during the surges. In all health care systems, provision of available critical care facilities is a scarce resource, even in normal times. Problematic is not just the limitation of physical spaces in intensive care units, but also the availab...

Background: Sciatica is a significant global health burden with a lifetime incidence estimated between 13% and 40%. In our study, we assessed the online health interest in sciatica and lower back pain. Material and methods: Google Trends, Wikipedia statistics and PubMed data were used to gauge the online public interest in sciatica and lower back p...

A 39-year-old man with a history of recurrent pituitary tumor, Cushing disease, and Nelson syndrome presented with neck stiffness. He previously had bilateral adrenalectomy and hypophysectomy 27 years ago. He subsequently had repeat pituitary surgery, stereotactic radiosurgery, and chemotherapy for recurrent pituitary tumor. During follow-up, he wa...

Background: Damage to the spinal cord is one of the most debilitating pathologies with considerable health, economic and social impact. Improved prevention, treatment and rehabilitation after spinal cord injury (SCI) requires the complex biomechanics of the spinal cord with all its structural elements and the injury mechanism to be understood. Thi...

We present the case of a 75-year-old man with a rapidly progressive cervical myelopathy on a background of a 3-year history of neck pain and a severely degenerative cervical spine. The patient developed progressive myelopathy over a six-month period and suffered from worsening kyphosis. Suspicion of an underlying oncological process prompted transf...

Background: Chondrosarcoma is an aggressive malignant bone neoplasm that accounts for almost 10% of all primary bone tumours. Nearly 10% of all chondrosarcomas occur in the spine. Due to its resistance to both radiation and chemotherapy, the mainstay of treatment is radical surgical excision. However, en bloc excision in the spinal tumours is compl...

Background Context Odontoid process fractures are the most common injuries of the cervical spine in the elderly. Anterior screw stabilisation of type 2 odontoid process fractures improves survival and function in these patients but may be complicated by failure of fixation. Purpose To determine whether cement augmentation of a standard anterior sc...

BACKGROUND There is no objective and readily accessible method for the preoperative determination of atypical characteristics of a meningioma grade. The aim of our study was to evaluate the feasibility of using fractal analysis as an adjunctive tool to conventional radiological techniques in identifying meningiomas with higher grade of malignancy....

PURPOSE The purpose of this study was to use fractal MR analysis and diffusion-weighted imaging (DWI) to determine if either can reliably differentiate WHO I benign from atypical WHO II meningiomas. METHODS 27 patients with atypical meningioma (WHO II) and 27 patients with benign meningioma (WHO I) were recruited from an institutional database (54...

Background Vertebroplasty carries multiple complications due to the leakage of polymethylmethacrylate (PMMA) into the venous system through the iliolumbar or epidural veins. The rate of venous cement complications may vary from 1 to 10 %, with cement extravasation into the venous system in 24 % of patients. Emboli may further migrate into the right...

Study design: A narrative review. Objectives: A literature review of studies reporting on the application of oblique corpectomy (OC) in various pathologies of the cervical spine. Setting: UK. Methods: A search was carried out using the PubMed and Google Scholar up to 18 March 2017. Finally, 26 studies met the inclusion criteria. Results: A...

Context: The Diffusion Tensor Imaging (DTI) is a modality of the MRI describing the integrity white matter tracts of the neural tissue by mean of fractional anisotropy (FA) and apparent diffusion coef cient (ADC). Aims: The aim of the study is to assess the usefulness of DTI in the acute assessment of patients after cervical tSCI. Settings and Desi...

Study design: Technical note. Objective: We describe a novel technique of bilateral longitudinal sacral osteotomy allowing direct reduction of high pelvic incidence (PI) and correction of sagittal imbalance. Methods: A 25-year-old female patient presented with a disabling lumbo-sacral kyphosis fused in situ through previous operations with res...

Lecture introducing most common pelvic entrapment neuropathies

Lecture presenting anatomical and physiological aspects of ALIF-related sexual dysfunctions

Lecture introducing recent advancements on the field of spinal oncology

Lecture introducing vertebral artery loops and a potential cause of cervical radiculopathy

Lecture presenting technical aspects of instrumentation allowing to decrease risk of construct failures in spinal oncology

Lecture presenting contemporary views on spinal LGH

The prognosis in cervical spinal cord injury (SCI) is poor and surgical and neuro intensive care management need further improvement. Monitoring of the intraspinal pressure (ISP) at early stage after tSCI is clinically useful. Obtaining continuous spinal cord perfusion pressure (SCPP) measurements based on the difference between mean arterial press...

Background: Cervical radiculopathies are rarely caused by vertebral artery loop formation, which is estimated to be present in less than 3% of patients. It is uncertain what causes the loop formation: some propose an association with spondylotic changes or trauma, whilst others suggest hypertension and atherosclerosis may be responsible. CASE REPO...

Objectives: The timing and modality of intervention in the treatment of poor-grade aneurysmal subarachnoid haemorrhage (aSAH) has not been defined. The purpose of the study is to analyse whether early treatment and type of intervention influence the clinical outcomes of poor-grade aSAH patients. Material and methods: Patients with poor-grade aSA...

Background context: To date no reliable method is available to determine the parameters of bone density based on the routine spinal CT in the emergency setup. We propose the use of fractal analysis to detect patients with poor quality of bone prior to urgent or semi-urgent spinal procedures. Purpose: To validate the hypothesis that the CT-based...

Background: There is no objective and readily accessible method for the preoperative determination of atypical characteristics of a meningioma grade. Objective: To evaluate the feasibility of using fractal analysis as an adjunctive tool to conventional radiological techniques in visualizing histopathological features of meningiomas. Methods: A...

Study design: Prospective case-control study. Objective: Aim of the study was to assess critical values of mechanical stress and strain in the cervical spinal cord based on the Finite Element Method (FEM) simulations of specified clinical cases. Summary of background data: The knowledge about the values and distribution of tension and deformation,...

Background: Traumatic brain injury (TBI) remains one of the leading causes of mortality and morbidity worldwide. The purpose of this study was to provide data on epidemiology of TBI in Poland during 2009-2012. Methods: The national data on hospitalizations with TBI as a primary diagnosis was obtained from the National Health Fund of Poland. The...

Technical note. In cases in which partial resection of the rib cage is accomplished with vertebrectomy, reconstruction of the chest wall may be challenging. That is because of lack of the anchor point which normally would be a proximal end of a rib or transverse process. We report a straightforward technique for chest wall reconstruction with the n...

Kidney transplantation has become the ideal and successful treatment for medically suitable patients with established kidney disease. This results in increased likelihood of these patients developing unrelated conditions requiring surgery, including spinal surgery. There are only a few publications available regarding spinal patients with renal tra...

Background: Obtaining the human olfactory bulb (OB) for treatment of spinal cord injuries with olfactory ensheathing cells (OECs) requires the elaboration of a surgical approach that could meet the criteria of safety and minimal invasiveness. The aim of the study was to evaluate the suitability of the keyhole supraorbital craniotomy (SOC) with an...

Treatment of patients sustaining a complete spinal cord injury remains an unsolved clinical problem because of the lack of spontaneous regeneration of injured central axons. A 38-year-old man sustained traumatic transection of the thoracic spinal cord at upper vertebral level Th9. At 21 months after injury, the patient presented symptoms of a clini...

The denticulate ligaments (DLs) are complex tissue structures that are composed of the edgings of the meninges connecting the side surface of the spinal cord and the spinal canal wall. It is due to this connection that the position of the central spinal cord can be maintained in the canal, mainly preventing the spinal cord from torsion. Additionall...

Background The dilemma concerning the appropriate treatment of the intracranial aneurysms (IAs) has not yet been resolved and still remains under fierce debate. This study refers to the recent trends in the use of and outcomes related to coiling compared with clipping for unruptured and ruptured IAs in Poland over a 4-year period. Methods The anal...

Numerous studies in animals have shown the unique property of olfactory ensheathing cells to stimulate regeneration of lesioned axons in the spinal cord. In a Phase I clinical trial, we assessed the safety and feasibility of transplantation of autologous mucosal olfactory ensheathing cells and olfactory nerve fibroblasts in patients with complete s...

Background. The purpose of the study was to test the suitability of supraorbital keyhole craniotomy with an eyebrow incision for obtaining olfactory bulb for therapeutic purposes. Methods. Fifty three high-resolution axial head computed tomography images of patients with a mean age of 55 ± 15 years were used. The exclusion criterion was a pathology...

Endoscopic third ventriculostomy (ETV) is the preferred method for treatment of noncommunicating hydrocephalus. The different success rates of ETV indicate the difficulties in prediction of the success of this procedure. To show the usefulness of intraoperative ventriculography performed by the low field 0.15 T magnetic resonance imager Polestar N2...

The aim of the study was to assess the safety and effectiveness of stereotactic brain tumour biopsy (STx biopsy) guided by low-field intraoperative magnetic resonance imaging (iMRI) in comparison with its frameless classic analogue based on a prospective randomized trial. A pilot group of 42 brain tumour patients was prospectively randomized into a...

Treatment of patients sustaining a complete spinal cord injury remains an unsolved clinical problem because of the lack of spontaneous regeneration of injured central axons. A 38-year-old man sustained traumatic transec-tion of the thoracic spinal cord at upper vertebral level Th9. At 21 months after injury, the patient presented symptoms of a clin...

Purpose: The most common pituitary tumors are adenomas, which however may be mimicked by other tumors that can show a very similar appearance in plain MRI. The aim of our study was to evaluate the usefulness of perfusion weighted MR imaging (PWI), including signal-intensity curves analysis in the differential diagnosis of sellar/parasellar tumors....

We present our early experience in intraoperative magnetic resonance (iMRI)-guided stereotactic frameless biopsies with special regard to its safety, efficacy and diagnostic value. The records of patients who underwent frameless stereotactic iMRI-guided biopsies between June 2009 and April 2011 were analysed prospectively. All the operations were p...

The aim of the study was to determine experimentally the stress as strain function as well as the orthotropy and heterogeneity of porcine dura mater of the cervical spinal cord. Material was divided into groups based on the place of collection, considering the dorsal side and ventral side, specifying the number of cervical vertebra, and the directi...

The aim of the study was to evaluate the efficiency of Finite Element Method (FEM) modelling of the clinical cases of traumatic cervical spinal cord injury (SCI). The study population consisted of 28 patients suffering from traumatic cervical spine injury with (study group) and without (control) neurological deficits. A numerical simulation of the...

The application of intraoperative magnetic resonance imaging (iMRI) is related to a series of challenges of both a technical and an organizational nature. We present our experience in the application of low-field iMRI in everyday neurosurgical practice. A group of 58 patients operated on using low-field iMRI was subject to prospective controlled ob...

Bilateral chronic subdural haemorrhage accompanying meningioma is a very rare clinical condition. We present a case of a 69-year-old female patient with large meningioma completely obliterating the posterior third part of the superior sagittal sinus with accompanying bilateral chronic subdural haematomas. Three anatomical zones of venous collateral...

Treatment of multiloculated hydrocephalus in children remains a difficult neurosurgical problem because of the high recurrence rate. Endoscopic septostomy with subsequent ventriculoperitoneal shunting is one of the most widely accepted therapeutic methods. Intraventricular endoscopic surgery combined with intraoperative magnetic resonance (MR) has...

The influence of mechanical load on the extent of nervous tissue damage in the spinal cord at the time of trauma is presently incontestable. Although numerical modelling cannot fully replace physical testing, it seems to be the perfect complement to experiments in terms of the analysis of such a complex phenomenon as traumatic spinal cord injury. P...

According to up-to-date knowledge only mathematical modelling of the spinal cord injury (SCI) may provide real insight into a spatial location of the fields of the spinal cord mechanical strain generated by the injury. The purpose of our research was to correlate the results of Finite Element Analysis of SCI with the patient's neurological state an...

Because of numerous abnormalities of craniovertebraljunction development observed in the prenatal period, the region has been studied thoroughly in order to elucidate the mechanism of axial differentiation, dependence of vertebral morphology on the development of ossification centers and the mechanisms regulating the dynamics of growth. Analysis of...

The neural arches, transverse processes, spinous processes, and superior and inferior articular processes of each of the 5 lumbar vertebrae can often be found under the common heading of 'posterior element'. The aim of our study was to assess the changes in geometry of the posterior elements of the foetal lumbar vertebrae during the foetal period....

Developmental abnormalities are the causes of numerous pathologies affecting the lumbar segment of the vertebral column. The aim of our study was metrologic assessment and analysis of lumbar vertebral column angioarchitecture during fetal life with particular emphasis on the description of vasculature of ossification centers of vertebral arches and...

The aim of our study was to elaborate a scheme for the development of the particular elements of the lumbar vertebral column in the foetal period based on metrological data analysis. 30 human foetuses between 31 and 183 mm C-R length were examined. The whole vertebral column and lumbar segment length, intervertebral spaces and structural elements o...