REHABILITATION PRINCIPLES FOR PATIENTS WITH METASTATIC SPINAL TUMORS

Today, changing living conditions, effective diagnostic and treatment methods have led to an increase in the prevalence of cancer. Problems such as pain, fatigue, and cognitive impairment are frequently observed in these patients due to cancer and its treatments, leading to the need for rehabilitation. Ad-vanced cancer can metastasize to various body parts. Spinal metastases, a common site of metastasis, may differ in that they can cause spinal instability and metastatic spinal cord compression. When planning a rehabilitation program for patients with spinal metastases, patients should be evaluated for the presence of spinal instability requiring surgery, activity modification, weight lifting restriction, and postural support. Metastatic spinal cord compression can occur in 2.5-5% of cancer patients. Pa-tients who develop non-traumatic spinal cord injury due to metastatic spinal cord compression may experience serious consequences such as ambulation difficulties, pain, spasticity, neurogenic bladder, and neurogenic bowel, which can lead to serious deterioration in quality of life. Additionally, there is a significant increase in the risk of complications such as decubitus ulcers and deep vein thrombosis. This increasingly increases the need for rehabilitation in these patients. For this purpose, in addition to pharmacological agents, many non-pharmacological methods such as orthotics and exercise can be used in rehabilitation. To ensure safety during rehabilitation planning for these patients, various issues concerning the cardiovascular, neurological, and musculoskeletal systems, as well as laboratory eval-uations, particularly cytopenias and electrolyte abnormalities, must be considered. The team involved in the rehabilitation of patients with spinal metastases must be aware of these potential problems, rearrange treatment plans when necessary, and utilize a multidisciplinary approach. Another import-ant consideration is the use of physical therapy agents. They can be used for purposes such as pain management, inflammation control, and muscle relaxation, after appropriate indications and contrain-dications have been identified. In addition, it is important to plan rehabilitation needs and management individually for each patient from the moment of diagnosis and to ensure safe discharge. This section will discuss the rehabilitation indications, methods, considerations, and discharge planning for patients with spinal metastases, starting from the moment of diagnosis.