Malignant Spinal Cord Compression

Ruppert, Lisa Marie

doi:10.1016/j.pmr.2016.08.007

Cited by 32 publications

(35 citation statements)

References 10 publications

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“…Patients may experience sensory changes, weakness, neurogenic bowel and bladder, and sexual dysfunction. 42,43 With any spine tumor, the foremost concern is spine stability and spinal cord integrity. Any new or progressive myelopathic symptoms require immediate imaging and surgical consultation for decompression and stabilization.…”

Section: Spine Sarcomasmentioning

confidence: 99%

“…Abdominal imaging and stool studies may be helpful. 43 If spasticity is present which is painful or functionally limiting, treatment with oral agents (such as baclofen and tizanidine) should be considered. Local injection with botulinum toxin or phenol nerve ablation may be beneficial for patients who cannot tolerate or do not derive sufficient benefit from oral regimens.…”

Section: Spine Sarcomasmentioning

confidence: 99%

See 1 more Smart Citation

<p>Rehabilitation to Improve the Function and Quality of Life of Soft Tissue and Bony Sarcoma Patients</p>

Andrews¹,

Siegel²,

Smith³

2020

PROM

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Sarcomas are bone and soft tissue tumors that can have significant effects on patient function and quality of life. Like most malignancies, treatment includes a combination of chemotherapy, radiation, and surgical resection, all of which also carry risks and long-term effects. A multidisciplinary rehabilitation plan can help minimize symptoms and sequelae which negatively affect the patient function and quality of life, including pain, chemotherapy-induced peripheral neuropathy, radiation fibrosis, activity restrictions following surgical excision, amputation, bowel and bladder dysfunction, and lymphedema. Patients should be evaluated by a rehabilitation specialist at any point during their diagnosis, treatment, and survivorship phase to determine appropriate interventions to minimize the impact of sarcomas and their treatment on patient function and quality of life.

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Section: Spine Sarcomasmentioning

confidence: 99%

Section: Spine Sarcomasmentioning

confidence: 99%

<p>Rehabilitation to Improve the Function and Quality of Life of Soft Tissue and Bony Sarcoma Patients</p>

Andrews¹,

Siegel²,

Smith³

2020

PROM

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“…The size of bone metastatic lesions is a risk factor for pathological fractures ( 7 ), and an enlarged bone metastasis in the vertebral body may induce spinal cord and nerve root compression ( 8 ). Bulky bone metastasis can cause SREs, and thus treatment to decrease or inhibit the growth of bone metastases is often required ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Radiographical efficacy of systemic treatment for bone metastasis from renal cell carcinoma

et al. 2020

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Enlarged bone metastasis from renal cell carcinoma (RCC) can cause skeletal-related events, and thus treatment to inhibit the growth of bone metastases is often required. Although radiotherapy for RCC bone metastases can achieve a certain degree of local control, evidence is lacking regarding the effects of systemic therapy to improve bone metastasis. The present study aimed to assess the treatment efficacy of targeted therapy and immune checkpoint inhibitors, and to determine whether systemic therapy without radiotherapy can shrink bone metastases of RCC. The present study retrospectively reviewed 44 patients with RCC with bone metastases treated via systemic therapy, including targeted therapy or immune checkpoint inhibitors. Patients were divided into two groups: Those who underwent systemic therapy with radiotherapy for bone lesions (n=29); and those who underwent systemic therapy without radiotherapy for bone lesions (n=15). The radiographical efficacy of systemic therapy and the time to progression of bone metastases were compared between groups. The overall response rate of systemic therapy with radiotherapy was 44%, and in total, 13 patients demonstrated a partial response. Only one patient (6%) had a partial response among those who were treated via systemic therapy without radiotherapy. The time to progression of bone metastasis was 9.5 and 2.1 months in patients treated with and without radiotherapy, respectively (P<0.0001). Collectively, the present results suggested that targeted therapy or immune checkpoint inhibitors without radiotherapy had only a slight effect on bone metastasis control.

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“…Among the different impairments in cancer patients, neoplastic spinal compression is unique because the severity of impairment (or of disability) does not correlate with the pathological grade of malignancy. The impairment is associated with the level of spinal cord injury and the volume of spinal compression [ 12 – 14 ]. Thus, we assume that disability from neoplastic spinal compression can be prevented with appropriate surgical, medical, and rehabilitative interventions aimed to treat these spine-specific factors and such interventions would be effective even in patients at the palliative stage.…”

Section: Introductionmentioning

confidence: 99%

Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization

et al. 2020

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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.

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Malignant Spinal Cord Compression

Cited by 32 publications

References 10 publications

<p>Rehabilitation to Improve the Function and Quality of Life of Soft Tissue and Bony Sarcoma Patients</p>

<p>Rehabilitation to Improve the Function and Quality of Life of Soft Tissue and Bony Sarcoma Patients</p>

Radiographical efficacy of systemic treatment for bone metastasis from renal cell carcinoma

Impairment-driven cancer rehabilitation in patients with neoplastic spinal cord compression using minimally invasive spine stabilization

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