Microsurgical repair of severed thoracic spinal cord and clinical outcome: technical case report

Chinese Neurosurgical Journal, 2022 · DOI: https://doi.org/10.1186/s41016-022-00286-0 · Published: January 1, 2022

Spinal Cord Injury Surgery Research Methodology & Design

Simple Explanation

This case report discusses a successful surgery on a young man with a severed spinal cord in his chest area due to a stab wound. The surgery involved reconnecting the severed cord using microsurgical techniques. Following surgery and intense physical therapy, the patient regained the ability to walk and move his legs normally. This suggests that repairing a severed spinal cord, along with rehabilitation, can lead to significant recovery. The report highlights the importance of considering spinal cord repair in similar cases, alongside removing any foreign objects. The ability of the spinal cord to heal and adapt after surgery and rehabilitation is crucial for a positive outcome.

Study Duration

18 Months

Participants

A 34-year-old male

Evidence Level

Level 4: Case Report

Key Findings

1
Microsurgical repair of a severed thoracic spinal cord is technically feasible and can lead to significant functional recovery.
2
Intense post-operative rehabilitation plays a crucial role in maximizing functional outcomes following spinal cord repair.
3
Spinal neuroplasticity, the ability of the spinal cord to adapt and reorganize, is a key factor in the healing process after timely repair and rehabilitation.

Research Summary

This case report describes the successful microsurgical repair of a severed thoracic spinal cord in a 34-year-old man who sustained a penetrating stab injury. The patient presented with Brown-Séquard syndrome and underwent urgent surgery to remove the knife and repair the severed cord. Post-operatively, the patient underwent intense neuro-rehabilitation, which led to significant improvement in motor function and mobility. At an 18-month follow-up, the patient was able to mobilize independently with normal lower limb power. The authors conclude that microsurgical repair of the severed spinal cord, combined with duroplasty and intense rehabilitation, should be considered in similar cases of penetrating spinal cord injury. The role of spinal neuroplasticity is highlighted as a key factor in the healing process.

Practical Implications

Surgical Intervention

Microsurgical repair should be considered in penetrating SCI.

Rehabilitation

Intensive rehabilitation is vital for functional recovery.

Neuroplasticity

Neuroplasticity plays a key role in spinal cord healing.

Study Limitations

1
Single case report limits generalizability.
2
Lack of neurophysiological monitoring during surgery.
3
Potential for selection bias in case presentation.

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