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Clinical Management and Rehabilitation of Spinal Cord Injury
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Clinical Management and Rehabilitation of Spinal Cord Injury

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 20 August 2025 | Viewed by 20415

Special Issue Editor

Dr. Tsunehiko Konomi

E-Mail Website
Guest Editor
National Hospital Organization Murayama Medical Center, Musashimurayama 208-0000, Japan
Interests: spinal trauma and spinal cord injury; pediatric scoliosis; adult deformity

Special Issue Information

Dear Colleagues,

Spinal cord injury (SCI) represents a complex and challenging medical condition with profound implications for individuals and their families. This Special Issue is dedicated to advancing our understanding of SCI and improving the clinical management and rehabilitation of SCI patients. With the increasing number of SCI cases worldwide, there is a pressing need to address research gaps and to improve treatment strategies and the quality of life of those affected.

The primary aim of this Special Issue is to provide a comprehensive platform for researchers, clinicians, and rehabilitation specialists to share cutting-edge research, evidence-based practices, and innovative approaches in the field of SCI. We seek to explore current research, identify core challenges, and propose effective solutions to enhance clinical care and rehabilitation outcomes.

The scope of this Special Issue includes topics such as SCI assessment and diagnosis, novel therapeutic interventions, assistive technologies, psychosocial support, and community reintegration. By combining expertise and knowledge from across the globe, we aspire to drive advancements in SCI care and rehabilitation that will positively impact the lives of individuals with SCI.

We welcome original research, clinical studies, reviews, and case reports that contribute to the advancement of SCI management and rehabilitation. Together, we can work towards a future where individuals with SCI experience improved clinical outcomes and an enhanced quality of life.

Dr. Tsunehiko Konomi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • spinal cord injury
  • rehabilitation
  • diagnosis and prognosis
  • comprehensive management
  • social support

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Published Papers (10 papers)

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Research

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10 pages, 185 KiB  
Article
The Current Epidemiology of Urinary Incontinence and Urinary Tract Infections After Spinal Cord Injury—A Model Systems Spinal Cord Injury Examination (2016–2021)
by Christopher Elliott, Evgeniy Kreydin, James Crew and Kazuko Shem
J. Clin. Med. 2025, 14(5), 1434; https://doi.org/10.3390/jcm14051434 - 21 Feb 2025
Viewed by 522
Abstract
Introduction: Neurogenic bladder disorders after spinal cord injury (SCI) are often problematic with urinary incontinence (UI) and recurrent urinary tract infections (UTIs) contributing to patient morbidity. Our study objective was to provide a current snapshot of the frequency of UI and UTIs [...] Read more.
Introduction: Neurogenic bladder disorders after spinal cord injury (SCI) are often problematic with urinary incontinence (UI) and recurrent urinary tract infections (UTIs) contributing to patient morbidity. Our study objective was to provide a current snapshot of the frequency of UI and UTIs in the SCI population while also quantifying their association with hospitalization. Methods: The National Spinal Cord Injury Database (2016–2021) was accessed for persons within five years of injury. The self-reported frequency of UI in the last month (none, daily, weekly, monthly), the number of UTIs requiring antibiotic treatment, and the number of hospitalizations (including reason) in the prior year were evaluated. Results: Our cohort comprised 5106 individuals within 5 years of SCI. Approximately 40% reported UI in the past month and over 50% had a UTI requiring antibiotics in the past year. Incontinence was significantly more frequent in those performing clean intermittent catheterization (CIC) (52% overall, 17% daily) compared to indwelling catheters (29% overall) or volitional void (22% overall) (p < 0.001 for each). Conversely, UTIs were most common in those using indwelling catheters (79% with at least one UTI) or CIC (70%) compared to diapers/condom catheters (46%) or volitional void (19%) (p < 0.001 for each). Increasing UI and UTI occurrences were both associated with an increased frequency of hospitalization in the prior year. Conclusions: UI and UTIs are common problems after SCI. While differing frequencies of UI and UTI are present based on bladder management, the overall frequency suggests that a continued emphasis on prevention is needed to potentially increase quality of life and decrease hospitalization. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
12 pages, 398 KiB  
Article
Association Between Sarcopenic Obesity and Activities of Daily Living in Individuals with Spinal Cord Injury
by Ryu Ishimoto, Hirotaka Mutsuzaki, Yukiyo Shimizu, Ryoko Takeuchi, Shuji Matsumoto and Yasushi Hada
J. Clin. Med. 2024, 13(23), 7071; https://doi.org/10.3390/jcm13237071 - 22 Nov 2024
Viewed by 924
Abstract
Background/Objectives: Sarcopenic obesity adversely affects physical function and activities of daily living (ADL) in older individuals and patients undergoing rehabilitation. This condition is also common in individuals with spinal cord injury (SCI); however, its relationship with ADL in this group remains unclear. [...] Read more.
Background/Objectives: Sarcopenic obesity adversely affects physical function and activities of daily living (ADL) in older individuals and patients undergoing rehabilitation. This condition is also common in individuals with spinal cord injury (SCI); however, its relationship with ADL in this group remains unclear. Hence, this study examined the association between sarcopenic obesity and ADL in individuals with SCI. Methods: This retrospective cross-sectional study identified sarcopenia using the low skeletal muscle mass index (SMI) and Asian Working Group for Sarcopenia reference values. Obesity was defined as a body fat percentage (%BF) exceeding 25% in men and 35% in women. Sarcopenic obesity was identified when both the sarcopenia and obesity criteria were met. The primary outcome, ADL, was measured using the Functional Independence Measure (FIM). Multiple linear regression models were used to analyze the associations among the SMI, %BF, and FIM scores, after adjusting for age, sex, lesion level, injury severity, comorbidities, and injury duration. Results: Of 82 participants (median age: 63.5 years; 18.3% women), 62.2% had sarcopenic obesity. Participants with sarcopenic obesity (54 vs. 69 points, p = 0.006) had significantly lower FIM motor scores than those without this condition. Multiple linear regression analysis revealed that SMI (β = 0.416, p < 0.001) and %BF (β = −0.325, p = 0.009) were independently associated with the FIM motor scores. Conclusions: Decreased SMI and increased %BF in patients with SCI were independently associated with decreased ADL independence. Routine body composition assessments are necessary for early detection and intervention in this population. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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10 pages, 641 KiB  
Article
Impact of Frailty on Functional Improvement Following Traumatic Spinal Cord Injury: A Japanese Single-Center Experience
by Tsunehiko Konomi, Minako Yoshikawa, Keita Kajikawa, Takahiro Kitagawa, Yoshiomi Kobayashi, Mitsuru Furukawa, Kanehiro Fujiyoshi and Yoshiyuki Yato
J. Clin. Med. 2024, 13(14), 4154; https://doi.org/10.3390/jcm13144154 - 16 Jul 2024
Viewed by 1298
Abstract
Study Design: This is a retrospective case series study. Objective: The aim of this study was to investigate whether frailty contributes to functional recovery in individuals with spinal cord injury (SCI). Methods: A total of 121 patients with SCI (106 cervical SCI, [...] Read more.
Study Design: This is a retrospective case series study. Objective: The aim of this study was to investigate whether frailty contributes to functional recovery in individuals with spinal cord injury (SCI). Methods: A total of 121 patients with SCI (106 cervical SCI, 15 thoracic SCI) discharged from our center over the past three years were studied. Moreover, 11-factor modified frailty index (mFI) scores, the length of hospital stays, the rate of returning home, and improvement in Spinal Cord Independence Measure (SCIM) scores were assessed retrospectively. Results: The average age at the time of injury for all 121 cases was 59.6 years. Based on pre-injury assessments, 24 cases were categorized as the Frail group, and 97 cases were categorized as the Robust group. The Frail group had SCIM improvement rates of 16.7% and a home discharge rate of 45.8%. In contrast, the Robust group had SCIM improvement rates of 33.5% and a home discharge rate of 68.0%, with statistically significant differences between the two groups. A significant negative correlation was observed between mFI scores and SCIM improvement rates (R = −0.231, p = 0.014). Conclusions: This study suggests that individuals with pre-existing frailty before SCI experience poorer SCIM improvement rates and face challenges in returning home. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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12 pages, 1477 KiB  
Article
An Innovative Method for the Conservative Treatment of Idiopathic Scoliosis Using the GraviSpine Device According to the Concept of Spinal Reflex Balance
by Marek Kluszczyński, Katarzyna Zaborowska-Sapeta, Ireneusz Kowalski and Ilona Sylwia Karpiel
J. Clin. Med. 2024, 13(14), 4044; https://doi.org/10.3390/jcm13144044 - 10 Jul 2024
Viewed by 1790
Abstract
Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early diagnosis in conjunction with the use of specific physiotherapy and bracing techniques. Our aim was to investigate the effectiveness of specific physiotherapy developed according to the concept of spinal [...] Read more.
Objectives: Conservative treatment of idiopathic scoliosis is more effective as a result of early diagnosis in conjunction with the use of specific physiotherapy and bracing techniques. Our aim was to investigate the effectiveness of specific physiotherapy developed according to the concept of spinal reflex balance using the GraviSpine device. This study is a retrospective analysis of prospectively collected data. Methods: A total of 199 patients aged 6–17 years, with a mean age of 11.26 ± 3.35 years, including 168 girls (84.4%) and 31 boys (15.6%), out of a total of 830 patients treated for IS at the Scoliosis Treatment Center in 2014–2019 were included in the assessment, which was conducted according to the inclusion and exclusion criteria. The study group was divided into three age groups. Group A subjects were 6–9 years old; group B, 10–12 years old; and group C, 13–17 years old. The mean follow-up time was 28.71 ± 10.98 months. Treatment outcomes were compared, based on changes in the Cobb angle and the angle of trunk rotation before and after treatment, both within the groups and with respect to sex and curvature location, using the Wilcoxon signed-rank test. Cobb angle changes in patients were classified as improvements, stabilizations, or deteriorations according to the SOSORT criteria. Results: A majority of patients improved or stabilized after treatment, with 67%, 71%, and 90% of subjects in groups A, B, and C, respectively, achieving these results. In group C (the oldest children), a statistically significant reduction of −1.84° ± 6.88° (6.31%) in the mean Cobb angle was achieved after treatment. With regard to sex, improvements and stabilizations accounted for 81% of cases in girls and 61% in boys, respectively. With respect to location, statistically significant reductions in the Cobb angle were noted for thoracic and thoracolumbar spines of −2.2° ± 7.54° (10.17%) p = 0.022 and −2.2° ± 6.58° (6.36%) p = 0.049, respectively. A significant reduction in the mean angle of trunk rotation was obtained in the group and in three curvature locations. Conclusions: Based on the presented research findings, the utilization of the GraviSpine device as an adjunct to specific PSSE (physiotherapeutic scoliosis-specific exercises) physiotherapy and bracing in the management of pediatric patients with mild to moderate scoliosis appears to enhance treatment efficacy. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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14 pages, 2569 KiB  
Article
Active Breaks Reduce Back Overload during Prolonged Sitting: Ergonomic Analysis with Infrared Thermography
by Martina Sortino, Bruno Trovato, Marta Zanghì, Federico Roggio and Giuseppe Musumeci
J. Clin. Med. 2024, 13(11), 3178; https://doi.org/10.3390/jcm13113178 - 29 May 2024
Viewed by 2854
Abstract
Background: Prolonged sitting is a potential risk factor for musculoskeletal disorders in office workers. This study aims to evaluate the effect of active breaks on reducing muscle overload in subjects who sit for long periods using infrared thermography (IRT). Methods: A sample of [...] Read more.
Background: Prolonged sitting is a potential risk factor for musculoskeletal disorders in office workers. This study aims to evaluate the effect of active breaks on reducing muscle overload in subjects who sit for long periods using infrared thermography (IRT). Methods: A sample of 57 office workers participated in this study and were divided into two groups: active breaks (ABs) and no active breaks (NABs). The NAB group sat continuously for 90 min without standing up, while the AB group performed stretching and mobility exercises every 30 min. IRT measurements were taken every 30 min before the active breaks. Results: The results highlight that the skin temperature of the back increased significantly in both groups after 30 min of sitting; however, in the subsequent measurements, the AB group showed a decrease in temperature, while the NAB group maintained a high temperature. Exercise and time point of measurement all reported p-values < 0.001; there were no statistically significant differences between the Δt0-1 of the NAB and AB groups, while the Δt1-2 and Δt1-3 of the NAB and AB groups showed statistically significant differences for all back regions. Conclusions: The clinical relevance of this study confirms the negative effects of prolonged sitting on the health of the back, demonstrating that active breaks can reduce back strain, emphasizing the need for workplace interventions. In addition, IRT represents a non-invasive method to assess back muscle overload and monitor the effectiveness of interventions in all categories of workers who maintain a prolonged sitting position. The main limitation of this study is the absence of a questionnaire for the assessment of back pain, which does not allow a direct correlation between temperature changes and back pain outcomes. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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Review

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14 pages, 1242 KiB  
Review
The Clinical Management of Electrical Stimulation Therapies in the Rehabilitation of Individuals with Spinal Cord Injuries
by David R. Dolbow, Ines Bersch, Ashraf S. Gorgey and Glen M. Davis
J. Clin. Med. 2024, 13(10), 2995; https://doi.org/10.3390/jcm13102995 - 20 May 2024
Cited by 2 | Viewed by 4414
Abstract
Background: People with spinal cord injuries (SCIs) often have trouble remaining active because of paralysis. In the past, exercise recommendations focused on the non-paralyzed muscles in the arms, which provides limited benefits. However, recent studies show that electrical stimulation can help engage the [...] Read more.
Background: People with spinal cord injuries (SCIs) often have trouble remaining active because of paralysis. In the past, exercise recommendations focused on the non-paralyzed muscles in the arms, which provides limited benefits. However, recent studies show that electrical stimulation can help engage the paralyzed extremities, expanding the available muscle mass for exercise. Methods: The authors provide an evidence-based approach using expertise from diverse fields, supplemented by evidence from key studies toward the management of electrical stimulation therapies in individuals with SCIs. Literature searches were performed separately using the PubMed, Medline, and Google Scholar search engines. The keywords used for the searches included functional electrical stimulation cycling, hybrid cycling, neuromuscular electrical stimulation exercise, spinal cord injury, cardiovascular health, metabolic health, muscle strength, muscle mass, bone mass, upper limb treatment, diagnostic and prognostic use of functional electrical stimulation, tetraplegic hands, and hand deformities after SCI. The authors recently presented this information in a workshop at a major rehabilitation conference. Additional information beyond what was presented at the workshop was added for the writing of this paper. Results: Functional electrical stimulation (FES) cycling can improve aerobic fitness and reduce the risk of cardiovascular and metabolic diseases. The evidence indicates that while both FES leg cycling and neuromuscular electrical stimulation (NMES) resistance training can increase muscle strength and mass, NMES resistance training has been shown to be more effective for producing muscle hypertrophy in individual muscle groups. The response to the electrical stimulation of muscles can also help in the diagnosis and prognosis of hand dysfunction after tetraplegia. Conclusions: Electrical stimulation activities are safe and effective methods for exercise and testing for motor neuron lesions in individuals with SCIs and other paralytic or paretic conditions. They should be considered part of a comprehensive rehabilitation program in diagnosing, prognosing, and treating individuals with SCIs to improve function, physical activity, and overall health. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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17 pages, 504 KiB  
Review
Spinal Cord Injury Management Based on Microglia-Targeting Therapies
by Thomas Gabriel Schreiner, Oliver Daniel Schreiner and Romeo Cristian Ciobanu
J. Clin. Med. 2024, 13(10), 2773; https://doi.org/10.3390/jcm13102773 - 8 May 2024
Cited by 2 | Viewed by 2048
Abstract
Spinal cord injury is a complicated medical condition both from the clinician’s point of view in terms of management and from the patient’s perspective in terms of unsatisfactory recovery. Depending on the severity, this disorder can be devastating despite the rapid and appropriate [...] Read more.
Spinal cord injury is a complicated medical condition both from the clinician’s point of view in terms of management and from the patient’s perspective in terms of unsatisfactory recovery. Depending on the severity, this disorder can be devastating despite the rapid and appropriate use of modern imaging techniques and convenient surgical spinal cord decompression and stabilization. In this context, there is a mandatory need for novel adjunctive therapeutic approaches to classical treatments to improve rehabilitation chances and clinical outcomes. This review offers a new and original perspective on therapies targeting the microglia, one of the most relevant immune cells implicated in spinal cord disorders. The first part of the manuscript reviews the anatomical and pathophysiological importance of the blood-spinal cord barrier components, including the role of microglia in post-acute neuroinflammation. Subsequently, the authors present the emerging therapies based on microglia modulation, such as cytokines modulators, stem cell, microRNA, and nanoparticle-based treatments that could positively impact spinal cord injury management. Finally, future perspectives and challenges are also highlighted based on the ongoing clinical trials related to medications targeting microglia. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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Other

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14 pages, 4804 KiB  
Systematic Review
The Prevalence of Adrenal Insufficiency in Individuals with Traumatic Spinal Cord Injury: A Systematic Review and Meta-Analysis
by Ali Hosseinzadeh, Rangchun Hou, Roy Rongyue Zeng, Martín Calderón-Juárez, Benson Wui Man Lau, Kenneth Nai Kuen Fong, Arnold Yu Lok Wong, Jack Jiaqi Zhang, Dalinda Isabel Sánchez Vidaña, Tiev Miller and Patrick Wai Hang Kwong
J. Clin. Med. 2025, 14(7), 2141; https://doi.org/10.3390/jcm14072141 - 21 Mar 2025
Viewed by 914
Abstract
Background/Objectives: Spinal cord injury (SCI) causes profound autonomic and endocrine dysfunctions, giving rise to adrenal insufficiency (AI), which is marked by a reduction in steroid hormone production. Left unaddressed, SCI-related AI (SCI-AI) can lead to life-threatening consequences such as severe hypotension and [...] Read more.
Background/Objectives: Spinal cord injury (SCI) causes profound autonomic and endocrine dysfunctions, giving rise to adrenal insufficiency (AI), which is marked by a reduction in steroid hormone production. Left unaddressed, SCI-related AI (SCI-AI) can lead to life-threatening consequences such as severe hypotension and shock (i.e., adrenal crisis). However, symptoms are often non-specific, making AI challenging to distinguish from similar or overlapping cardiovascular conditions (e.g., orthostatic hypotension). Additionally, the etiology of SCI-AI remains unknown. This review aimed to synthesize the current literature reporting the prevalence, symptomology, and management of SCI-AI. Methods: A systematic search was performed to identify studies reporting AI following the cessation of glucocorticoid treatments in individuals with traumatic SCI. A random-effects meta-analysis was conducted to investigate the overall prevalence of SCI-AI. Results: Thirteen studies involving 545 individuals with traumatic SCI, most with cervical level injuries (n = 256), met the review criteria. A total of 4 studies were included in the meta-analysis. Primary analysis results indicated an SCI-AI pooled prevalence of 24.3% (event rate [ER] = 0.243, 95% confidence interval [CI] = 0.073–0.565, n = 4). Additional sensitivity analyses showed a pooled prevalence of 46.3% (ER = 0.463, 95%CI = 0.348–0.582, n = 2) and 10.8% (ER = 0.108, 95%CI = 0.025–0.368, n = 2) for case–control and retrospective cohort studies, respectively. High-dose glucocorticoid administration after SCI as well as the injury itself appear to contribute to the development of AI. Conclusions: The estimated prevalence of AI in people with traumatic SCI was high (24%). Prevalence was also greater among individuals with cervical SCI than those with lower-level lesions. Clinicians should be vigilant in recognizing the symptomatology and onset of SCI-AI. Further research elucidating its underlying pathophysiology is needed to optimize glucocorticoid administration for remediating AI in this vulnerable population. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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9 pages, 3128 KiB  
Case Report
Impact of Combined Neuromuscular Electrical Stimulation (Comb-NMES) on Glucose Signaling and Muscle Myofiber Distribution in a Patient with Acute Spinal Cord Injury and Lower Motor Neuron Lesion
by Amal Alharbi, Erika Womack and Ceren Yarar-Fisher
J. Clin. Med. 2025, 14(3), 876; https://doi.org/10.3390/jcm14030876 - 28 Jan 2025
Viewed by 779
Abstract
Introduction: This case report examines the impact of a novel combined neuromuscular electrical stimulation (Comb-NMES) regimen on muscle glucose signaling, fiber type distribution, and metabolic function in a patient with acute spinal cord injury (SCI) and lower motor neuron lesions (LMNLs). Case Report: [...] Read more.
Introduction: This case report examines the impact of a novel combined neuromuscular electrical stimulation (Comb-NMES) regimen on muscle glucose signaling, fiber type distribution, and metabolic function in a patient with acute spinal cord injury (SCI) and lower motor neuron lesions (LMNLs). Case Report: A 32-year-old male with complete T9 SCI underwent a ten-session Comb-NMES intervention targeting the quadriceps. Muscle biopsies and blood samples were analyzed pre- and post-intervention to evaluate changes in muscle fiber types, key metabolic proteins, fasting insulin, glucose, and lipid profiles. Results: The intervention led to a 74.7% and 28.2% reduction in fasting insulin and glucose, respectively. Muscle analysis showed significant increases in CaMK II, Hexokinase II, and IRS-1, indicating improved glucose metabolism. Conclusions: Comb-NMES training markedly improved metabolic control and muscle glucose metabolism in a patient with acute SCI and LMNLs. Enhanced insulin sensitivity and glucose utilization were evidenced by upregulated metabolic proteins, which suggests that Comb-NMES is a promising intervention for improving muscle and metabolic health in SCI patients with LMNLs. Further studies are needed to confirm these benefits and explore the long-term effects. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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14 pages, 1629 KiB  
Systematic Review
Comprehensive Insights into Metastasis-Associated Spinal Cord Compression: Pathophysiology, Diagnosis, Treatment, and Prognosis: A State-of-the-Art Systematic Review
by Michail Vavourakis, Evangelos Sakellariou, Athanasios Galanis, Panagiotis Karampinas, Dimitrios Zachariou, Georgios Tsalimas, Vasileios Marougklianis, Evangelia Argyropoulou, Meletis Rozis, Angelos Kaspiris and Spiros G. Pneumatikos
J. Clin. Med. 2024, 13(12), 3590; https://doi.org/10.3390/jcm13123590 - 19 Jun 2024
Cited by 1 | Viewed by 3624
Abstract
Background: Spinal cord compression is a formidable complication of advanced cancer, and clinicians of copious specialities often have to encounter significant complex challenges in terms of diagnosis, management, and prognosis. Metastatic lesions from cancer are a common cause of spinal cord compression, affecting [...] Read more.
Background: Spinal cord compression is a formidable complication of advanced cancer, and clinicians of copious specialities often have to encounter significant complex challenges in terms of diagnosis, management, and prognosis. Metastatic lesions from cancer are a common cause of spinal cord compression, affecting a substantial portion of oncology patients, and only in the US has the percentage risen to 10%. Acute metastasis-correlated spinal cord compression poses a considerable clinical challenge, necessitating timely diagnosis and intervention to prevent neurological deficits. Clinical presentation is often non-specific, emphasizing the importance of thorough evaluation and appropriate differential diagnosis. Diagnostic workup involves various imaging modalities and laboratory studies to confirm the diagnosis and assess the extent of compression. Treatment strategies focus on pain management and preserving spinal cord function without significantly increasing patient life expectancy, while multidisciplinary approaches are often required for optimal outcomes. Prognosis depends on several factors, highlighting the importance of early intervention. We provide an up-to-date overview of acute spinal cord compression in metastases, accentuating the importance of comprehensive management strategies. Objectives: This paper extensively explores the pathophysiology, clinical presentation, diagnostic strategies, treatment modalities, and prognosis associated with spinal cord metastases. Materials and Methods: A systematic literature review was conducted in accordance with the PRISMA guidelines. Conclusions: We aim to help healthcare professionals make informed clinical decisions when treating patients with spinal cord metastases by synthesizing current evidence and clinical insights. Full article
(This article belongs to the Special Issue Clinical Management and Rehabilitation of Spinal Cord Injury)
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