Improvement After Surgery in a Patient With Prolonged Tetraplegia Due to Cervical Spinal Cord Injury Without Bone Injury

Cureus, 2023 · DOI: 10.7759/cureus.33420 · Published: January 5, 2023

Spinal Cord Injury Surgery Rehabilitation

Simple Explanation

This case report describes a patient with a spinal cord injury in the neck area without any broken bones. He experienced paralysis in all four limbs after a fall. Initially, the patient was treated with conservative methods such as rehabilitation. However, after eight months, his condition hadn't improved. Therefore, he underwent surgery to relieve pressure on his spinal cord. Following the surgery and continued rehabilitation, the patient showed significant improvement in his ability to move his legs and walk. This suggests that surgery can be a viable option even in chronic cases.

Study Duration

20 Months

Participants

1 patient: a 48-year-old man

Evidence Level

Level 4: Case Report

Key Findings

1
Conservative treatment alone did not improve the patient's paralysis eight months after the injury.
2
Decompression surgery, performed eight months post-injury, significantly improved the patient's lower limb motor function.
3
The combination of late surgery and intensive postoperative rehabilitation led to improved outcomes, including gait ability one year postoperatively.

Research Summary

This case report describes the successful surgical management of a patient with chronic cervical spinal cord injury (CSCI) without major bone injury (CSCIw) who experienced prolonged tetraplegia. The patient, initially treated conservatively for eight months without improvement, underwent decompression surgery and subsequent rehabilitation, leading to significant gains in motor function and gait ability. The findings suggest that surgical intervention, even in the chronic phase, can be a viable option for improving outcomes in select CSCIw patients when combined with postoperative rehabilitation.

Practical Implications

Consider Late Surgery

Surgical treatment may be considered even in chronic CSCIw cases where conservative treatment fails to provide functional improvement.

Importance of Postoperative Rehabilitation

Intensive rehabilitation is crucial for maximizing the benefits of surgery in chronic CSCIw patients.

Individualized Treatment Approach

Prognosis prediction using clinical imaging and physical motion findings is essential to determine the ideal treatment method for each patient.

Study Limitations

1
Single case report limits generalizability
2
Insufficient evidence on prognosis prediction using findings in the early phase of the injury
3
Need for larger studies with quantitative parameters

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