Halo-vest for cervical pain in a home care patient with esophageal cancer and cervical spine metastases

Introduction：Halo-vest is usually used temporary to immobilize the cervical spine after surgery or injury. We experienced a good pain relief by halo-vest attachment in one patient with metastatic tumors of cervical spine. Case：A 76-year-old male patient was diagnosed with cervical spine metastases during chemotherapy treatment for lymph node recurrence 7 years after the first surgery for his esophageal cancer. His neck and back pain did not improve even after pain management by analgesics and radiotherapy. He also experienced strong side effects due to opioid treatment. Eventually, he became immobile. Halo-vest was applied solely for the purpose of pain control. Since then, his pain diminished, opioid stopped and his gait recovered. After moving to a hospital close to his home, he was discharged from the hospital. He could stay at home without a severe complication and opioids for 2 months. Discussion：Fixation of the cervical spine with halo-vest might be a good procedure for pain relief in patients with cervical spine metastases. However, since it could also be a stressful treatment and might cause a severe complication, thorough discussion for the use of a halo-vest is mandatory with the patient, family, and orthopedists.

Study on introducing and the efficacy of horticulture therapy for palliative care of patients

<b>Purpose</b>: As integrated medicine has been receiving more attention, therapeutic effect of plants has become more evident in recent years. However, many hospitals in Japan have not taken advantage of horticultural therapy in their palliative care unit yet. In the present study, we examined the role and the experience of horticulture as an individual therapy for patients in palliative care unit. <b>Results and Discussion</b>: More smiles were observed on the patients as evident from their Face scale score changes on days horticultural therapy was conducted. Coming into contact with the vital force of plants, through germination, flowering, and seed setting seemed to act as an effective care for the patients. Comparison of the nurses' daily journal and horticultural therapists' logbook showed difference in the nature of conversations recorded, indicating a specific role of horticultural therapists in palliative care. <b>Conclusion</b>: The study suggested a potential for individual therapy of patients with horticulture in palliative care as a part of integrated medicine that requires involvement of multiple medical disciplines.