Perspectives on Spinal Precautions in Patients Who Have Cancer and Spinal Metastasis

Research output: Contribution to journalReview article

1 Scopus citations


Bones are the third most common site for cancer metastases, and the axial skeleton is the most frequent skeletal location. In a postmortem study, bone metastases were reported in 70% of breast and prostate cancer patients. Bone metastases from breast, lung, prostate, thyroid, and kidney cancers account for 80% of all bone metastases. Bone lesions exist in 60% of newly diagnosed multiple myeloma patients. With increasing numbers of people who have survived cancer, many patients with cancer and axial skeletal bony metastases will be seen by physical and occupational therapists. Guidelines are lacking on how to perform physical examinations and provide exercise programs for these patients without compromising the diseased spine. In this article, we discuss the available evidence for similar spinal conditions, the biomechanics of spinal load, and changes associated with posture and weight load. We provide recommendations on how to assess a patient's strength, how to strengthen without compromising the diseased spine, and how to teach patients to use correct body mechanics during mobility and activities of daily living.

Original languageEnglish (US)
Pages (from-to)554-563
Number of pages10
JournalPhysical Therapy
Issue number3
StatePublished - Mar 10 2020

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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