Article
Neoplastic versus traumatic spinal cord injury: An outcome comparison after inpatient rehabilitation,☆☆

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Abstract

Objective: To compare outcomes of patients with neoplastic spinal cord compression (SCC) to outcomes of patients with traumatic spinal cord injury (SCI) after inpatient rehabilitation.

Design: A comparison between patients with a diagnosis of neoplastic SCC admitted to an SCI rehabilitation unit and patients with a diagnosis of traumatic SCI admitted to the regional Model Spinal Cord Injury Centers over a 5-year period, controlling for age, neurologic level of injury, and American Spinal Injury Association impairment classification.

Setting: Tertiary university medical centers.

Patients: Twenty-nine patients with neoplastic SCC and 29 patients with SCI of traumatic etiology who met standard rehabilitation admission criteria.

Main Outcome Measures: Acute and rehabilitation hospital length of stay (LOS), Functional Independence Measure (FIM) scores, FIM change, FIM efficiency, and discharge rates to home.

Results: Patients with neoplastic SCC had a significantly (p < .01) shorter rehabilitation LOS than those with traumatic SCI (25.17 vs 57.46 days). No statistical significance was found in acute care LOS. Motor FIM scores on admission were higher in the neoplastic group, but discharge FIM scores and FIM change were significantly lower. Both groups had similar FIM efficiencies and community discharges.

Conclusions: Patients with neoplastic SCC can achieve rates of functional gain comparable to those of their counterparts with traumatic SCI. While patients with traumatic SCI achieve greater functional improvement, patients with neoplastic SCC have a shorter rehabilitation LOS and can achieve comparable success with discharge to the community.

References (32)

  • R Kim et al.

    Extradural spinal cord compression: analysis of factors determining functional prognosis-prospective study

    Radiology

    (1990)
  • N Sundaresan et al.

    Treatment of neoplastic epidural cord compression by vertebral body resection and stabilization

    J Neurosurg

    (1985)
  • N Sundaresan et al.

    Vertebral body resection in the treatment of cancer involving the spine

    Cancer

    (1984)
  • S Helweg-Larsen

    Clinical outcome in metastatic spinal cord compression

  • HS Greenburg et al.

    Epidural spinal cord compression from metastatic tumor: results with a new treatment protocol

    Ann Neurol

    (1980)
  • N Sundaresan et al.

    Surgical treatment of spinal cord compression from epidural metastasis

    J Clin Oncol

    (1995)
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    Supported in part by grant H133N50015 from the National Institute on Disability and Rehabilitation Research, Bethesda, MD, to the Regional Spinal Cord Injury Center of the Medical College of Virginia, Virginia Commonwealth University.

    ☆☆

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

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