Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization
Abstract Background Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabil...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12957-020-01964-y |
| _version_ | 1818991564682166272 |
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| author | Yukako Ishida Hideki Shigematsu Shinji Tsukamoto Yasuhiko Morimoto Eiichiro Iwata Akinori Okuda Sachiko Kawasaki Masato Tanaka Hiromasa Fujii Yasuhito Tanaka Akira Kido |
| author_facet | Yukako Ishida Hideki Shigematsu Shinji Tsukamoto Yasuhiko Morimoto Eiichiro Iwata Akinori Okuda Sachiko Kawasaki Masato Tanaka Hiromasa Fujii Yasuhito Tanaka Akira Kido |
| author_sort | Yukako Ishida |
| collection | DOAJ |
| description | Abstract Background Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabilitation with minimally invasive spine stabilization (MISt) effectively improves ADL. Methods We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with MISt. We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability, and tumor growth. The neurological deficits, progress of pathological fracture, incidence of vertebral collapse, and postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses. Results The average duration to ambulation was 7.19 ± 11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. Neurological deficiency was improved to or maintained at Frankel’s grade E in 16 patients, remained unchanged in 6 patients (in grades B, C, D), and worsened in 5 patients. BI score comparisons before and after surgery in all patients showed statistically significant increments (p < 0.05). On further analysis, we noted good functional prognosis in patients capable of ambulation within 7 days (p < 0.05) and in patients who could survive longer than 3 months after the surgery (p < 0.05). Conclusions In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores. |
| first_indexed | 2024-12-20T20:12:16Z |
| format | Article |
| id | doaj.art-f4fd400bc3564340868f78b69f39bf5b |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-20T20:12:16Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-f4fd400bc3564340868f78b69f39bf5b2022-12-21T19:27:48ZengBMCWorld Journal of Surgical Oncology1477-78192020-07-011811910.1186/s12957-020-01964-yImpairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilizationYukako Ishida0Hideki Shigematsu1Shinji Tsukamoto2Yasuhiko Morimoto3Eiichiro Iwata4Akinori Okuda5Sachiko Kawasaki6Masato Tanaka7Hiromasa Fujii8Yasuhito Tanaka9Akira Kido10Department of Rehabilitation Medicine, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Rehabilitation Medicine, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Orthopedic Surgery, Nara Medical UniversityDepartment of Rehabilitation Medicine, Nara Medical UniversityAbstract Background Neoplastic spinal cord compression is a cause of severe disability in cancer patients. To prevent irreversible paraplegia, a structured strategy is required to address the various impairments present in cancer patients. In this study, we aimed to identify the status where rehabilitation with minimally invasive spine stabilization (MISt) effectively improves ADL. Methods We retrospectively reviewed 27 consecutive patients with neoplastic spinal compression who were treated with MISt. We classified the impairments of patients through our multidisciplinary tumor board based on spine-specific factors, skeletal instability, and tumor growth. The neurological deficits, progress of pathological fracture, incidence of vertebral collapse, and postoperative implant failure were examined. Changes of the Barthel index (BI) scores before and after surgery were investigated throughout the clinical courses. Results The average duration to ambulation was 7.19 ± 11 days, and we observed no collapse or progression of paralysis except in four cases of complete motor paraplegia before the surgery. Neurological deficiency was improved to or maintained at Frankel’s grade E in 16 patients, remained unchanged in 6 patients (in grades B, C, D), and worsened in 5 patients. BI score comparisons before and after surgery in all patients showed statistically significant increments (p < 0.05). On further analysis, we noted good functional prognosis in patients capable of ambulation within 7 days (p < 0.05) and in patients who could survive longer than 3 months after the surgery (p < 0.05). Conclusions In various cancer patients with neoplastic spinal cord compression, skeletal instability as the primary impairment is a good indication for MISt, as the patients showed early ambulation with improved BI scores.http://link.springer.com/article/10.1186/s12957-020-01964-yImpairmentCancer rehabilitationPercutaneous pedicle screwsSpinal metastasisMinimally invasive spine stabilization |
| spellingShingle | Yukako Ishida Hideki Shigematsu Shinji Tsukamoto Yasuhiko Morimoto Eiichiro Iwata Akinori Okuda Sachiko Kawasaki Masato Tanaka Hiromasa Fujii Yasuhito Tanaka Akira Kido Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization World Journal of Surgical Oncology Impairment Cancer rehabilitation Percutaneous pedicle screws Spinal metastasis Minimally invasive spine stabilization |
| title | Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization |
| title_full | Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization |
| title_fullStr | Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization |
| title_full_unstemmed | Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization |
| title_short | Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization |
| title_sort | impairment driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization |
| topic | Impairment Cancer rehabilitation Percutaneous pedicle screws Spinal metastasis Minimally invasive spine stabilization |
| url | http://link.springer.com/article/10.1186/s12957-020-01964-y |
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