Rehabilitation and treatment of spinal cord tumors

Raj, Vishwa S.; Lofton, LaTanya

doi:10.1179/2045772312y.0000000015

Cited by 48 publications

(53 citation statements)

References 76 publications

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“…4 It can also result in retropulsion of fractured bone fragments into the epidural space causing spinal cord compression. 5 …”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

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Malignant Spinal Cord Compression

Ruppert

2017

Physical Medicine and Rehabilitation Clinics of North America

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Synopsis Spinal tumors are classically grouped into three categories, extradural tumors, intradural extramedullary tumors and intradural intramedullary tumors. Spinal tumors may cause spinal cord compression and vascular compromise resulting in pain or neurological compromise. They may also alter the architecture of the spinal column, resulting in spinal instability. Oncologic management of spinal tumors varies according to the stability of the spine, neurological status and presence of pain. Treatment options include surgical intervention, radiation therapy, chemotherapy and hormonal manipulation. When combined with this management, rehabilitation can serve to relieve symptoms, improve quality of life, enhance functional independence, and prevent further complications in patients with malignant spinal cord compression

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“…4 It can also result in retropulsion of fractured bone fragments into the epidural space causing spinal cord compression. 5 …”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

“…3 ESCC is most commonly diagnosed in thoracic lesions; though cadaveric studies have shown that the most common site of tumor burden in the spine is the lumbar region. 5 …”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Malignant Spinal Cord Compression

Ruppert

2017

Physical Medicine and Rehabilitation Clinics of North America

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“…10,16,[19][20][21] Despite the high proportion of people with tumor causing SCDys there has been relatively little written about these patients in terms of the ideal setting for their rehabilitation or recommendations for rehabilitation teams caring for them. 10,16,19,20,22 The objectives of this project were: 1) to provide a brief review of the epidemiology, clinical features and outcomes for patients with SCDys due to tumor, 2) to survey participants attending a workshop on the rehabilitation of people with SCDys due to tumor about the admission practices of their SRU regarding these people and the services available for their rehabilitation, and 3) based on evidence from the literature and our expert opinion, propose practical considerations for staff working in SRU when managing people with SCDys due to tumor.…”

Section: Introductionmentioning

confidence: 99%

“…14,19,20,22,32 Survey There were 40 workshop participants who worked as health care professionals in rehabilitation who completed the survey. It is estimated that the response rate was close to 100%.…”

mentioning

confidence: 99%

Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation

New

Marshall²,

Stubblefield

et al. 2016

The Journal of Spinal Cord Medicine

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9Spinal Rehabilitation (SpiRe) laboratory, IRCCS Fondazione S. Lucia, Rome, Italy Background/Objectives: People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs). Design: Survey of rehabilitation health care professionals, consensus opinion from experts and literature search. Setting: Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada. Participants: Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor. Outcomes Measures: Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission. Results: Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs. Conclusions: A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes.

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“…6 The MSCC population is heterogeneous; however, common physical impairments that impact quality of life and functional independence include neuropathic and nociceptive pain, immobility, bowel and bladder dysfunction, and loss of skin integrity. 7 Inpatient rehabilitation services will take greater prominence in the management of MSCC-related impairments with advances in its detection, medical and surgical management, and survival. 8 A recent systematic review of retrospective cohort studies suggests that patients with neoplastic myelopathy achieve comparable gains in the Functional Independence Measure (FIM) score relative to their non-cancer counterparts with similar impairments.…”

Section: Introductionmentioning

confidence: 99%

Inpatient rehabilitation outcomes in patients with malignant spinal cord compression compared to other non-traumatic spinal cord injury: A population based study

Fortin¹,

Voth

Jaglal³

et al. 2015

The Journal of Spinal Cord Medicine

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Objective: To compare and describe demographic characteristics, clinical, and survival outcomes in patients admitted for inpatient rehabilitation following malignant spinal cord compression (MSCC) or other causes of non-traumatic spinal cord injury (NT-SCI). Design: A retrospective cohort design was employed, using data retrieved from administrative databases. Outcome measures: Demographic, impairment, functional outcome (as defined by the Functional Independence Measure (FIM)), discharge, healthcare utilization, survival, and tumor characteristics. Results: There was a significant improvement in the FIM from admission to discharge (mean change 20.1 ± 14.3, <0.001) in the MSCC cohort. NT-SCI patients demonstrated a higher FIM efficiency (1.2 ± 1.7 vs. 0.8 ± 0.8, <0.001) and higher total (24.0 ± 14.4 vs. 20.1 ± 14.3, <0.001) FIM gains relative to MSCC cases. However, there were no differences between the MSCC and NT-SCI cohorts in length of stay (34.6 ± 30.3 vs. 37.5 ± 35.2, P = 0.8) or discharge FIM (100.7 ± 19.6 vs. 103.3 ± 18.1, P = 0.1). Three-month, 1-year, and 3-year survival rates in the MSCC and NT-SCI cohorts were 76.2% vs. 97.6%, 46.2% vs. 93.7%, and 27.3% vs. 86.7%, respectively. The majority (65.0%) of patients with MSCC was discharged home and met their rehabilitation goals (75.5%) at comparable rates to patients with NT-SCI (69.7 and 81.3%). Conclusion: Despite compromised survival, patients with MSCC make clinically significant functional gains and exhibit favorable discharge outcomes following inpatient rehabilitation. Current administrative data suggests the design and scope of inpatient rehabilitation services should reflect the unique survival-related prognostic factors in patients with MSCC.

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Rehabilitation and treatment of spinal cord tumors

Cited by 48 publications

References 76 publications

Malignant Spinal Cord Compression

Malignant Spinal Cord Compression

Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation

Inpatient rehabilitation outcomes in patients with malignant spinal cord compression compared to other non-traumatic spinal cord injury: A population based study

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