Impact of Neurorehabilitation on Functional Recovery in patients with Intradural Spinal Cord Tumors: A retrospective analysis in a resource-limited setting

Abstract

Objective: To assess the functional outcomes in patients with intradural spinal neoplasms following neurorehabilitation.

Methodology: This retrospective case series was conducted in the Physiotherapy Department of Punjab Institute of Neurosciences, from July 2024 to December 2024. Data was collected from medical records of patients who underwent surgical resection of intradural spinal cord space-occupying lesions (SOL) followed by neurorehabilitation. Neurorehabilitation in this study comprised individualized, structured programs incorporating evidence-based manual therapy techniques, neurodevelopmental approaches, and task-specific training, delivered by specialized physical therapists. The treatment plans were designed according to patient needs and focused on restoring mobility, reducing spasticity, improving muscle strength, and enhancing independence in daily activities. Functional outcomes were assessed using the Numeric Pain Rating Scale (NPRS), Modified Ashworth Scale (MAS), Oxford Manual Muscle Testing (MMT), and Spinal Cord Independence Measure (SCIM). Assessments were performed following neurorehabilitation.

Results: A total of 10 patients were included, with a mean age of 38.33 ± 23.71 years; 80% (8) were female. Most participants, 70% (7) had intradural extramedullary (IDEM) tumors, while 30% (3) had intradural intramedullary (IDIM) tumors. Post-rehabilitation, NPRS scores significantly decreased from 6.70 ± 0.95 to 2.50 ± 0.85. MAS scores improved from 2.80 ± 0.42 to 1.60 ± 0.52, indicating reduced spasticity. MMT scores increased from 2.00 ± 0.47 to 3.30 ± 0.48, demonstrating improved muscle strength. SCIM scores improved from 31.40 ± 4.99 to 63.50 ± 8.89, highlighting enhanced functional independence.

Conclusion: Neurorehabilitation particularly early initiation and frequent, structured sessions using manual therapy and neurodevelopmental techniques significantly improves pain levels, muscle tone, strength, and functional independence in patients following surgical resection of intradural spinal tumors. Early and structured rehabilitation programs do play a crucial role in optimizing post-operative recovery in these patients.