Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Understanding the Role of Rehabilitation Medicine in the Care of Patients with Tumor Causing Spinal Cord Dysfunction

  • 55 Accesses

  • 2 Citations

Abstract

Purpose of Review

People with tumor (benign or malignant)-causing spinal cord dysfunction (SCDys) present many rehabilitation challenges. These patients have varying prognoses and complications related to their spinal cord damage. This review highlights the role of rehabilitation medicine in the care of patients with tumor-causing spinal cord dysfunction.

Recent Findings

People with SCDys due to tumor can face barriers in accessing specialist spinal cord rehabilitation, especially those with malignant tumor. Evidence supports the admission of people with SCDys due to tumor into specialist spinal rehabilitation units as the ideal setting for inpatient rehabilitation. Once in the community, these people have an ongoing need for access to specialist spinal rehabilitation.

Summary

A framework and practical considerations for managing people with SCDys due to tumor are proposed. Patients with tumor-causing SCDys should be given a greater access to specialist spinal rehabilitation in order to achieve the best outcomes.

This is a preview of subscription content, log in to check access.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    Wong DA, Fornasier VL, MacNab I. Spinal metastases: the obvious, the occult, and the impostors. Spine. 1990;15(1):1–4.

  2. 2.

    Loblaw DA, Laperriere NJ, Mackillop WJ. A population-based study of malignant spinal cord compression in Ontario. Clin Oncol. 2003 Jun;15(4):211–7.

  3. 3.

    Schellinger KA, Propp JM, Villano JL, McCarthy BJ. Descriptive epidemiology of primary spinal cord tumors. J Neuro-Oncol. 2008;87(2):173–9.

  4. 4.

    New PW, Sundararajan V. Incidence of non-traumatic spinal cord injury in Victoria, Australia: a population-based study and literature review. Spinal Cord. 2008;46:406–11.

  5. 5.

    Noonan VK, Fingas M, Farry A, Baxter D, Singh A, Fehlings MG, et al. The incidence and prevalence of SCI in Canada: a national perspective. Neuroepidemiology. 2012;38:219–26.

  6. 6.

    New PW, Marshall R. International Spinal Cord Injury Data Sets for non-traumatic spinal cord injury. Spinal Cord. 2014;52:123–32.

  7. 7.

    New PW, Cripps RA, Lee BB. A global map for non-traumatic spinal cord injury epidemiology: towards a living data repository. Spinal Cord. 2014;52:97–109.

  8. 8.

    •• New PW, Reeves RK, Smith É, Eriks-Hoogland I, Gupta A, Scivoletto G, et al. International retrospective comparison of inpatient rehabilitation for patients with spinal cord dysfunction: differences according to etiology. Arch Phys Med Rehabil. 2016;97:380–5. Largest international study of non-trauamtic SCDys reported to date. Provides comparison of demographic characterists, clinical features and outcomes by etiology, including malignant and benign tumor.

  9. 9.

    •• New PW, Marshall R, Stubblefield MD, Scivoletto G. Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation. J Spinal Cord Med. Published online: 18 Apr 2016: http://dx.doi.org/10.1080/10790268.2016.1173321. Provides a report of the epidemiology and outcomes for manageing people with spinal cord damage due to tumor, including recommendations for teams in spinal rehabilitation units based in evidence in the literature and consensus opinion from a panel of experts.

  10. 10.

    Murray PK. Functional outcome and survival in spinal cord injury secondary to neoplasia. Cancer. 1985;55:197–201.

  11. 11.

    McKinley WO, Conti-Wyneken AR, Vokac CW, Cifu DX. Rehabilitative functional outcome of patients with neoplastic spinal cord compression. Arch Phys Med Rehabil. 1996;77:892–5.

  12. 12.

    Parsch D, Mikut R, Abel R. Postacute management of patients with spinal cord injury due to metastatic tumour disease: survival and efficacy of rehabilitation. Spinal Cord. 2003;41:205–10.

  13. 13.

    Eriks I, Angenot E, Lankhorst G. Epidural metastatic spinal cord compression: functional outcome and survival after inpatient rehabilitation. Spinal Cord. 2004;42:235–9.

  14. 14.

    Fattal C, Gault D, Leblond C, Gossens D, Schindler F, Rouays-Mabit H, et al. Metastatic paraplegia: care management characteristics within a rehabilitation center. Spinal Cord. 2009;47:115–21.

  15. 15.

    Scivoletto G, Lapenna L, Di Donna V, Laurenza L, Sterzi S, Foti C, et al. Neoplastic myelopathies and traumatic spinal cord lesions: an Italian comparison of functional and neurological outcomes. Spinal Cord. 2011;49:799–805.

  16. 16.

    Tan M, New PW. Retrospective study of rehabilitation outcomes following spinal cord injury due to tumour. Spinal Cord. 2012;50:127–31.

  17. 17.

    • Fortin CD, Voth J, Jaglal SB, Craven BC. Inpatient rehabilitation outcomes in patients with malignant spinal cord compression compared to other non-traumatic spinal cord injury: a population based study. J Spinal Cord Med. 2015;38:754–64. A population-based study that highlights the benefits from rehabilitation for people with malignant tumor causing spinal cord damage compared with other causes of SCDys.

  18. 18.

    New PW, Scivoletto G, Smith É, Townson A, Gupta A, Reeves RK, et al. International survey of perceived barriers to admission and discharge from spinal cord injury rehabilitation units. Spinal Cord. 2013;51:893–7.

  19. 19.

    McKinley WO, Huang ME, Tewksbury MA. Neoplastic vs. traumatic spinal cord injury: an inpatient rehabilitation comparison. Am J Phys Med Rehabil. 2000;79(2):138–44.

  20. 20.

    New PW. Functional outcomes and disability after nontraumatic spinal cord injury rehabilitation: results from a retrospective study. Arch Phys Med Rehabil. 2005;86:250–61.

  21. 21.

    Tan M, New PW. Survival after rehabilitation for spinal cord injury due to tumor: a 12-year retrospective study. J Neuro-Oncol. 2011;104:233–8.

  22. 22.

    Fattal C, Fabbro M, Gelis A, Bauchet L. Metastatic paraplegia and vital prognosis: perspectives and limitations for rehabilitation care. Part 1. Arch Phys Med Rehabil. 2011;92:125–33.

  23. 23.

    Celani MG, Spizzichino L, Ricci S, Zampolini M. Franceschini M, for the retrospective study group on SCI. Spinal cord injury in Italy: a multicenter retrospective study. Arch Phys Med Rehabil. 2001;82:589–96.

  24. 24.

    Smith M. Efficacy of specialist versus non-specialist management of spinal cord injury within the UK. Spinal Cord. 2002;40:11–6.

  25. 25.

    New PW, Simmonds F, Stevermuer T. A population-based study comparing traumatic spinal cord injury and non-traumatic spinal cord injury using a national rehabilitation database. Spinal Cord. 2011;49:397–403.

  26. 26.

    Ruff RL, Ruff SS, Wang X. Persistent benefits of rehabilitation on pain and life quality for nonambulatory patients with spinal epidural metastasis. J Rehablil Res Dev. 2007;44:271–8.

  27. 27.

    New PW, Townson A, Scivoletto G, Post MWM, Eriks-Hoogland I, Gupta A, et al. International comparison of the organisation of rehabilitation services and systems of care for patients with spinal cord injury. Spinal Cord. 2013;51:33–9.

  28. 28.

    Ruff RL, Adamson VW, Ruff SS, Wang X. Directed rehabilitation reduces pain and depression while increasing independence and satisfaction with life for patients with paraplegia due to epidural metastatic spinal cord compression. J Rehablil Res Dev. 2007;44:1–10.

  29. 29.

    New PW, Simmonds F, Stevermuer T. Comparison of patients managed in specialised spinal rehabilitation units with those managed in non-specialised rehabilitation units. Spinal Cord. 2011;49:909–16.

  30. 30.

    New PW. Non-traumatic spinal cord injury: what is the ideal setting for rehabilitation? Aust Health Rev. 2006;30:353–61.

  31. 31.

    • Hasnan N, Engkasan JP, Ramakrishnan K, Fauzi AA, Yusof YM, Htwe O, et al. Follow-up after spinal cord injury. In: Chhabra HS, editor. ISCoS textbook on comprehensive management of spinal cord injuries. New Delhi, India: Wolters Kluwer; 2015. p. 888–905. Review of the rational for and approach to the rehabilitation medicine follow-up of people with spinal cord damage after hospital discharge. Not specifically directed at people with SCDys due to tumor, but relevant general principles.

  32. 32.

    McColl MA, Shortt S, Godwin M, Smith K, Rowe K, O’Brien P, et al. Models for integrating rehabilitation and primary care: a scoping study. Arch Phys Med Rehabil. 2009;9:1523–31.

  33. 33.

    Eldar R. Integrated institution-community rehabilitation in developed countries: a proposal. Disabil Rehabil. 2000;22:266–74.

  34. 34.

    Forchheimer M, Tate DG. Enhancing community re-integration following spinal cord injury. NeuroRehabilitation. 2004;19:103–13.

  35. 35.

    Cox RJ, Amsters DI, Pershouse KJ. The need for a multidisciplinary outreach service for people with spinal cord injury living in the community. Clin Rehabil. 2001;15:600–6.

  36. 36.

    Stubblefield MD, O’Dell MW. Cancer rehabilitation. Principles and practice. New York: Demos Medical Publishing; 2009.

  37. 37.

    Stubblefield MD, Bilsky MH. Barriers to rehabilitaiton of the neurosurgical spine cancer patient. J Surg Oncol. 2007;95:419–26.

  38. 38.

    Stubblefield MD. Barriers to rehabilitation of the malignant spine. Topics in Spinal Cord Injury Rehabilitation. 2008;14:19–30.

  39. 39.

    Eva G, Paley J, Miller M, Wee B. Patients’ constructions of disability in metastatic spinal cord compression. Palliat Med. 2009;23:132–40.

  40. 40.

    McKinley W. Rehabilitation of patients with spinal cord dysfunction in the cancer setting. In: Stubblefield MD, O’Dell MW, editors. Cancer rehabilitation principles and practice. New York: Demos Medical Publishing; 2009. p. 533–50.

  41. 41.

    Raj VS, L L. Rehabilitation and treatment of spinal cord tumors. J Spinal Cord Med. 2013;36:4–11.

Download references

Author information

Correspondence to Peter Wayne New.

Ethics declarations

Conflict of Interest

The author declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Cancer Rehabilitation

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

New, P.W. Understanding the Role of Rehabilitation Medicine in the Care of Patients with Tumor Causing Spinal Cord Dysfunction. Curr Phys Med Rehabil Rep 5, 40–45 (2017). https://doi.org/10.1007/s40141-017-0142-0

Download citation

Keywords

  • Delivery of health care
  • Neoplasms
  • Rehabilitation
  • Spinal cord diseases
  • Spinal cord injury