Management of Fecal Incontinence Caused by Spine Metastasis Treatment

Sacral Nerve Stimulation (SNS)

The American Cancer Society recommends a two-stage approach for SNS, including a temporary external SNS trial period, followed by permanent neurostimulation device implantation if successful, for patients with fecal incontinence caused by spine metastasis treatment 1
The National Comprehensive Cancer Network suggests that SNS is most effective in incomplete cauda equina syndrome where some sacral nerve function remains, and is not recommended for complete denervation 1

The American College of Surgeons advises that sphincter reconstruction and other complex surgical interventions should be restricted to highly selected patients only, due to significant morbidity and limited applicability in the metastatic spine population 2, 1

The National Institute of Health recommends designating a responsible physician to coordinate all aspects of bowel management, and ensuring the primary care physician or palliative care team is actively involved and well-informed 2, 1
The American Academy of Hospice and Palliative Medicine emphasizes that palliative care principles should be applied, paying attention to physical, psychological, social, and spiritual aspects of care 1