放射線脊髄障害による対麻痺を呈した脊椎原発悪性リンパ腫患者のリハビリテーション

概要

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This case report describes establishing the restorative rehabilitation goal for a 71-year-old female suffering from primary malignant lymphoma of the thoracic spine and radiation myelopathy who had previously received only palliative therapy. Primary malignant lymphoma of bone origin is very rare and has a survival rate of 58% at 5 years after onset with little mortality thereafter, based upon the data of 174 patients at Mayo Clinic. In 1991 she had back pain and gait disturbance which improved after treatment with surgery, radiation and chemotherapy in that year. She developed complete paraplegia due to radiation myelopathy, and had been almost totally dependent in ADL's at a hospice until admission to our rehabilitation hospital in 1996. The primary goal was independence in ADL using a wheelchair. We felt this was possible based on her physical condition, laboratory examination including bone scintigram, and her expected long term prognosis based on studies in the literature. Therefore we shifted the program from palliative rehabilitation to restorative. Eventually she became independent in activities of transfer and self-catheterization, and changed her attitude to be much more positive. In cancer rehabilitation, it is important to plan the program based on the prognosis of the disease as well as the patient's physical condition.
社団法人日本リハビリテーション医学会の論文
1998-04-18