Inpatient rehabilitation outcomes in neoplastic spinal cord compression vs. traumatic spinal cord injury

Abstract

Objective: To compare neurological and functional outcomes, and complications of patients with neoplastic vs traumatic spinal cord injury (SCI) after in-patient rehabilitation. Design: This study is a retrospective analysis. Setting: In-patient rehabilitation unit of a tertiary research hospital. Participants: A total of 252 patients with a SCI were included; 43 with neoplastic SCI (mean age: 60.9 +/- 15.7 years, 60.5% were males) and 209 with traumatic SCI (mean age: 43.1 +/- 16.8 years, 71.3% were males). Outcome measures: Comparisons were made of demographic characteristics, etiology, American Spinal Injury Association (ASIA) impairment scale, functional independence measurement (FIM) and Functional Ambulation Categories (FAC) scores, length of stay (LOS), bladder independence, medical comorbidities and complications in both groups. Results: Patients with neoplastic SCI were significantly older than those with traumatic SCI (P < 0.01). No difference was present between the groups in terms of sex and lesion level (P > 0.05). Incomplete SCI was significantly higher in the neoplastic group when compared with the traumatic group (P < 0.01). The LOS was significantly shorter in the neoplastic group than traumatic group (34.8 +/- 41.03 vs. 60.02 +/- 53.1, P < 0.01). There were no differences in the admission FIM scores (69.3 +/- 24.7 vs. 58.7 +/- 18.9, P > 0.05), discharge FIM scores (82.1 +/- 25.1 vs. 74.02 +/- 23.3, P > 0.05) and FIM efficiencies (0.43 +/- 0.72 vs. 0.36 +/- 0.51, P > 0.05) for the neoplastic and traumatic groups, respectively. However, neoplastic SCI patients demonstrated lower FIM gains compared to traumatic patients (12.9 +/- 11.9 vs. 15.4 +/- 15.2, P < 0.05). During rehabilitation, urinary tract infection (48.4% vs. 69.4%) and decubitus ulcer (11.6% vs. 35.9%) were significantly more common in the traumatic group than the neoplastic group (P < 0.05). Conclusion: Neoplastic SCI patients who commonly present at rehabilitation units exhibit different characteristics from traumatic SCI patients but the rehabilitation results are similar. Similar functional development can be achieved in a shorter period of time with inpatient rehabilitation in the neoplastic SCI group.