Surgery and subsequent rehabilitation for cervical spine tumours compressing neural structures.
Bone malignancies account for merely about 1.5% of all cancers, with a small percentage of these tumours developing in the cervical spine. However, the cervical spine is also the site of benign tumours and neoplasms involving not only bony tissue. Benign tumours do not metastasize but pose a threat to the spinal cord when located intrathecally. Even though such tumours do not represent malignancy, they are considered to be locally malignant. The most common cervical spine neoplasms are intradural tumours, usually extramedullary: neurofibromas, meningiomas or gliomas.Indications for surgery depend of the nature and location of the tumour and the consequences of tumour growth. Surgery is obviously necessary for intrathecal tumours compressing the spinal cord. The choice of surgical approach and manner of stabilisation depend primarily on the location of the lesion and the presence of spinal cord compression.Rehabilitation is indicated in all patients, but is particularly important, and at the same time difficult, when the growth of the tumour has resulted in neurological disturbances. The task is all the more difficult when in the presence of a massive and high spinal cord damage. Rehabilitation programmes should be designed individually for each patient and should account for the degree of paresis, stage of the underlying malignant disease, survival prognosis, disturbances in the function of other systems, apart from musculoskeletal apparatus, age of the patient, his or her commitment to treatment and other factors.The treatment of malignant neoplasms is usually associated with an unfavourable outcome. However, combination drug treatments, radiation therapy and surgery with subsequent rehabilitation will often prolong survival, ameliorate suffering and improve patients' quality of life.
Kiwerski
Jerzy E
JE
Department of Physiotherapy, Medical University of Warsaw, Poland.
D000367:Age Factors; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation*; D011379:Prognosis; D011788:Quality of Life; D013117:Spinal Cord Compression / Q000209:etiology* / Q000517:prevention & control; D013125:Spinal Neoplasms / Q000150:complications* / Q000601:surgery*