Favorable evolution on functional key components but with multiple remaining phatological elements in a patient diagnosed with toraco-lombar SCI - Case report

• Main Authors: PETCU Irina Raluca, SERBAN Daniel, DELCEA Florin, BADIU Dumitru Cristinel, OPREA (MANDU) Mihaela, POPESCU Cristina, ONOSE Gelu
• Format: Article
• Language: English
• Published: Romanian Association of Balneology, Editura Balneara 2020-12-01
• Series: Balneo Research Journal
• Subjects: spine-cord injury; paraplegia; poly-pathologic; rehabilitation
• Online Access: http://bioclima.ro/Balneo401.pdf

Introduction: This paper presents an extremely complex case: paraplegia with T11 neurological level after a thoraco-lumbar spinal cord injury (SCI), with T12 commutative fracture, by falling from about 2 meters (operated on 17.02.2020), currently having an AIS/ Frankel C motor deficit, with multiple complications and successive aggravation, as well as the approach of its therapeutically-rehabilitation management. Materials and methods: 41-year-old male patient admitted to our Clinical Division for motor deficiency of paraplegia type, immediately postoperative AIS/ Frankel C, currently AIS/ Frankel D, for superficial sensitivity disorders with T11 level was clinically and functionally evaluated, according to the implemented standard protocols of our Clinic, by the following measurement evaluation scales: AIS, FIM, QQL (Quality of life), Ashworth, Penn, FAC, WISCI II and investigated paraclinical). Duringh hospitalization, the patient presented numerous aggravations and complications such as: urinary tract infection with E. Coli; left epididymo-orchities, all this aggravating and delaying therapeutic procedures, respectively recovery results. Results: Following an optimal treatment including pharmacological and a complex neuro-rehabilitation program, the patient had a favorable evolution with increased values of the measurement scales (motor AIS with 13 points, FIM motor with 5 points, QQL with 9 points, and FAC with 1 point ); incomplet remission of the bladder and neurogenic bowel dysfunction (intermittent urinary catheterization); increased muscle strength with improved walking speed and balance. Conclusion: The rehabilitation of patients with spinal cord injury is a complex process which requires taking into account all associated pathologies that can play a decisive role in the evolution of the patient. A multidisciplinary team is required for such purposes.