The effect of timing on rehabilitation results in tumor-related spinal cord injuries.

Abstract

Objectives: This study aims to investigate the impact of early initiated rehabilitation on outcomes in patients with spinal cord injuries related to tumors.

Patients and methods: In this retrospective cohort study conducted between January 2015 and March 2021, a total of 31 patients with tumor-related spinal cord injury were assessed. Two patients were excluded due to incomplete clinical records, and the remaining 29 patients were divided into the early rehabilitation group (n=15; 8 males, 7 females; mean age: 45.53±16.73 years; range: 8 to 68 years) and the late rehabilitation group (n=14; 9 males, 5 females; mean age: 54.86±14.76 years; range: 28 to 78 years). Demographic and clinical characteristics, Functional Ambulation Category (FAC), and Barthel Index scores for outcome measurement were recorded.

Results: The neurological level of the patients was predominantly at the thoracic level. The majority of patients were in the American Spinal Injury Association D category. In the evaluation of treatment outcomes, a significant difference was observed within each group of FAC and Barthel Index scores before and after rehabilitation (p=0.034, p=0.002; p=0.007, p=0.005 in early and late rehabilitation groups). In the comparison of FAC and Barthel Index scores before and after rehabilitation between groups, there was a significant difference in favor of the late rehabilitation group in both scores, both before and after rehabilitation (respectively, before rehabilitation p=0.032, p=0.005; after rehabilitation p=0.026, p=0.003). However, there was no significant difference in the FAC difference and Barthel Index scores percentage changes between groups.

Conclusion: This study demonstrates that functional outcomes improved with rehabilitation in patients with spinal cord injuries related to tumors. Although the timing of rehabilitation initiation did not result in significant differences in functional outcomes, early rehabilitation did not appear to increase the risk of surgery-related adverse events.