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

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.