Background: Short- and long-term consequences after treatment for childhood fossa posterior tumors are extensively reported in the literature; however, papers highlighting physical function throughout rehabilitation and its correlation with Intelligence Quotient (IQ) are sparse. This study aims to describe the physical functioning and IQ of these survivors, their progression during rehabilitation, and the association with histopathological tumor classification. Additionally, the correlation between gross motor functioning and cognitive functioning was investigated. Methods: This retrospective single-center cohort study included 56 children (35 (62.5%) males and 21 (37.5%) females, with an average age of 6.51 years (SD 4.13)) who followed a multidisciplinary program at the Child Rehabilitation Centre, Ghent University Hospital in the period from 2005 to 2020. Descriptive statistical analysis was performed with the use of non-parametric tests and linear regression to determine the relationship between gross motor functioning and IQ. Results: This report shows impaired motor and intelligence performance in children with a fossa posterior tumor. Although multidisciplinary rehabilitation is beneficial, it is not able to counteract the further decline of several motor skills and intelligence during oncological treatment, more specifically in children with a medulloblastoma. A correlation between gross motor function and total IQ was found. Conclusion: Pediatric survivors of a fossa posterior tumor experience impaired physical and intellectual functions, with more decline during oncological treatment despite simultaneous multidisciplinary rehabilitation.
Musculoskeletal pain involving a region of the spine with radiation to the head, trunk, or extremities is relatively common in daily medical practice, such as upper- neck pain with headache, lower-neck pain and discomfort in the shoulders and arms, or low-back pain with sciatica. The instability of a vertebral segment produces a persistent barrage of nociceptive impulses that trigger peripheral and central sensitization phenomena, affecting the metamere innervated by the corresponding nerve root. This process produces clinical manifestations of hyperalgesia and/or allodynia in dermatomes, myotomes, and sclerotomes with a typical regional distribution known as spinal segmental sensitization (SSS). The activation of new peripheral nociceptive foci within the affected metamere can further aggravate the clinical picture. This disorder is usually classified as non-specific for being a somatosensory nervous system dysfunction without evident structural damage, which can lead to confusion since the magnitude of pain and disability reported by the patient appear to be disproportionate to the findings of auxiliary tests. In the absence of a timely diagnosis and adequate treatment, patients may resort to alternative therapies, which often do not solve the problem. The use of a standardized set of diagnostic criteria will help clinicians identify SSS and help researchers conduct studies in homogeneous populations. This review of its pathophysiology provides a foundation for rationally and systematically establishing the best treatment schemes and thus will benefit the many patients who suffer from this syndrome, which represents a challenge for
