Challenge or opportunity: Rehabilitation outcomes in patients with metastatic spinal cord compression – a UK single center experience

Abstract

Context /Objective Metastatic Spinal Cord Compression (MSCC) is a devastating complication of cancer, affecting approximately 3000 patients per annum in England. However, access to rehabilitation services for MSCC patients is limited. The London Spinal Cord Injury Centre has set up a bespoke MSCC rehabilitation pathway from May 2013. This article aims to describe the clinical features and functional outcomes of patients with MSCC admitted to a Specialist Spinal Cord Injury Rehabilitation Centre between May 2013 and December 2021. Design Retrospective analysis of medical records from a single specialist rehabilitation centre database. Setting London Spinal Cord Injury Centre (LSCIC), Stanmore, United Kingdom. Participants Adult patients diagnosed with MSCC who were admitted to and discharged from LSCIC from May 2013 to December 2021. Interventions Specialist Inpatient Spinal Cord Injury Rehabilitation Program. Outcome Measures Spinal Cord Independence Measure 19 (SCIM version III), Discharge Destination. Results A total of 40 patients with MSCC were admitted – 32 male and 8 female patients. The average length of stay was 6 weeks. 17(42.5%) patients had primary prostate cancer. Most patients (34(85%)) had thoracic MSCC. There was an improvement in the Spinal Cord Independence Measure in all patients with an average significant improvement from 43.8 to 64.5 (P < 0.001). There was no significant difference in SCIM scores between patients under 65 and over 65. 28 (70%) patients required psychological input. 33(82.5%) patients were discharged home. Conclusion Patients with MSCC show improvement in SCIM outcome measures after a six-week inpatient Specialist Spinal Rehabilitation program.