Radiation Myelitis Risk After Hypofractionated Spine Stereotactic Body Radiation Therapy.

Importance: Stereotactic body radiation therapy (SBRT) for spinal metastases improves symptomatic outcomes and local control compared to conventional radiotherapy. Treatment failure most often occurs within the epidural space, where dose is constrained by the risk of radiation myelitis (RM). Current constraints designed to prevent RM after spine SBRT are derived from limited data.

Autonomic dysreflexia in patients with cancer and spinal cord injury: a case series.

Introduction: Autonomic dysreflexia (AD) is a potentially life-threatening syndrome that can occur in patients with traumatic injury to the spinal cord; however, it has not been well described in patients with non-traumatic spinal cord injury (SCI) from cancer and its treatments.

Case Presentation: We report four cases of autonomic dysreflexia secondary to primary spinal cord tumors and metastatic disease to the spine, and as sequela to cancer treatment. The clinical characteristics, diagnostic considerations, and therapeutic strategies used to mitigate the symptoms are discussed.

Role of Rehabilitation in Spine Tumors.

Primary and metastatic spine tumors can lead to devastating complications, but timely and careful management of these patients can improve outcomes. A multidisciplinary and structured approach is the most effective way to evaluate patients with spine disease and mitigate the risk of complications. The neurologic, oncologic, mechanical and systemic disease framework gives comprehensive guidance to providers regarding appropriate management.

Post-acute Care Needs and Benefits of Inpatient Rehabilitation Care for the Oncology Patient.

Purpose Of Review: This study aims to assess recent literature published on the post-acute care needs of cancer patients, specifically focusing on the acute inpatient rehabilitation setting.

Recent Findings: The neurologic cancer population appears to be the most studied oncologic population in acute inpatient rehabilitation studies within the past 5 years. This finding is consistent with prior findings from the past several decades.

Patient outcomes following implementation of an enhanced recovery after surgery pathway for patients with metastatic spine tumors.

Background: Metastatic spine tumor surgery consists of palliative operations performed on frail patients with multiple medical comorbidities. Enhanced recovery after surgery (ERAS) programs involve an evidence-based, multidisciplinary approach to improve perioperative outcomes. This study presents clinical outcomes of a metastatic spine tumor ERAS pathway implemented at a tertiary cancer center.

Spine Pain and Metastatic Prostate Cancer: Defining the Contribution of Nonmalignant Etiologies.

Purpose: In patients with metastatic prostate cancer (MPC), the contribution of nonmalignant etiologies to morbidity is often overlooked.

Methods: We retrospectively reviewed the documented specialist assessments of back pain in men with MPC in a joint medical oncology and physiatry clinic at our tertiary cancer care center. Data on cancer disease extent, hormonal status, sites of spread, pain characteristics, physiatric examination findings, imaging, and recommended management were reviewed, extracted, and codified.

Metastatic spine oncology: symptom-directed management.

Spinal tumors pose significant treatment challenges for the physicians treating them. Understanding the location of the tumor within the intramedullary, intradural extramedullary, or extradural (epidural) space is not only critical in determining a differential diagnosis but may also provide important information about current and future neurologic deficits. Despite significant advances in the treatment of spinal tumors over the past few decades, these patients may still experience significant symptoms related to the tumor or its treatment, such as pain, weakness, impaired sensation, and bowel and bladder dysfunction.

Training and Practice Patterns in Cancer Rehabilitation: A Survey of Physiatrists Specializing in Oncology Care.

Background: Cancer rehabilitation is an integral part of the continuum of care for survivors. Due to the increasing number of survivors, physiatrists commonly see cancer patients in their general practices. Essential to guiding the field is to understand the current training and practice patterns of cancer rehabilitation physicians.

Managing bowel and bladder impairments in sacral chordoma patients: a case-based approach.

Introduction: Chordomas are primary bone tumors that occur in the axial spine and most commonly in the sacrum. Because of their location, chordomas can affect bowel and bladder continence resulting in either an upper or a lower motor neuron functional pattern.

Case Presentation: We present two cases describing chordoma's impact on bowel and bladder function and the management plan used for improvement.

Malignant Spinal Cord Compression: Adapting Conventional Rehabilitation Approaches.

Spinal tumors are classically grouped into 3 categories: extradural, intradural extramedullary, and intradural intramedullary. Spinal tumors may cause spinal cord compression and vascular compromise resulting in pain or neurologic compromise. They may also alter the architecture of the spinal column, resulting in spinal instability.

Segmental zoster paresis of the left upper limb in a pediatric patient.

Segmental zoster paresis of the left upper limb in a pediatric patient.Segmental zoster paresis is a rare complication of herpes zoster characterized by focal, asymmetrical motor weakness in the myotome that corresponds to the dermatome of the rash. Segmental zoster paresis typically develops within 2-3 wks of cutaneous zoster and predominantly affects the middle-aged and elderly populations.