Metastatic paraplegia and functional outcomes: perspectives and limitations for rehabilitation care. Part 2

Arch Phys Med Rehabil. 2011 Jan;92(1):134-45. doi: 10.1016/j.apmr.2010.09.016.

Abstract

Objective: To identify functional outcomes that could justify the need for a rehabilitation care program for patients with metastatic epidural spinal cord compression (MESCC) and paraplegia.

Data sources: Publications from 1950 to January 2010 selected from 3 databases.

Study selection: Original articles dealing with outcome data for functional status, pain, and bladder dysfunction.

Data extraction: Standardized reading grid.

Data synthesis: The data are dominated by retrospective studies for even functional-related data, and studies from rehabilitation teams are rare. They report a functional evolution similar to a population with traumatic spinal cord injury for the first 3 months. Patients who were ambulatory before treatment retained their ability to walk, and patients who were nonambulatory before treatment could regain gait abilities. Data also showed a positive impact on pain and bladder and/or bowel dysfunction.

Conclusions: By restricting physical medicine and rehabilitation therapeutic care to a short time (1-2mo), the progression margin is possible in the short term and implies a voluntary and active therapeutic care approach for patients with paraplegia after MESCC on the basis of a codified and standardized program with clinical indicators, as well as patients' comfort indicators.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Humans
  • Pain / etiology
  • Pain / rehabilitation
  • Paraplegia / etiology*
  • Paraplegia / mortality
  • Paraplegia / rehabilitation*
  • Prognosis
  • Socioeconomic Factors
  • Spinal Cord Compression / complications*
  • Spinal Neoplasms / complications*
  • Spinal Neoplasms / mortality
  • Spinal Neoplasms / secondary*
  • Time Factors
  • Urinary Bladder Diseases / etiology
  • Urinary Bladder Diseases / rehabilitation