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Rehabilitative functional outcome of patients with neoplastic spinal cord compressions
W O McKinley1, A R Conti-Wyneken, C W Vokac
1Department of Physical Medicine and Rehabilitation, Medical College of Virginia, Richmond 23298, USA.
Objective:
To examine functional outcome and descriptive data of individuals with neoplastic spinal cord compression admitted to a rehabilitation unit.
Design:
A 5-year review of consecutive patients admitted to a spinal cord injury rehabilitation unit with a diagnosis of neoplastic spinal cord compression.
Setting:
A tertiary university medical center.
Patients:
Thirty-two consecutive patients with neoplastic spinal cord compression who met standard rehabilitation admission criteria and had a prognosis of no less than 3 months' survival.
Main Outcome Measures:
Functional data, including length of stay, functional outcomes (utilizing Functional Independent Measurement scores in mobility and self-care), bladder management, and disposition.
Results:
Lung (28%) and prostate (17%) were the most common tumor types, and upper thoracic (40%) was the most common level of spinal cord involvement. Functional Independent Measure improvements were found in all areas, with significant improvements (paired t test, p < .005) noted in the areas of upper and lower extremity dressing, grooming, toilet and tub transfers, wheelchair use and transfers, ambulation, and stair climbing. Average length of rehabilitation stay was 27 days, and 84% of the patients were discharged to home. Seventy-five percent of the 20 responders to a follow-up survey had maintained or improved their discharge functional abilities at 3 months after discharge.
Conclusions:
These data suggest that in individuals with spinal cord compression caused by neoplastic invasion, functional improvements in mobility and self-care can be achieved and maintained for at least 3 months after discharge.