Spontaneous Recovery of Penetrating Cervical Spinal Cord Injury with Physiotherapeutic Treatment: Case Report and Review of the Literature

Case Reports in Neurological Medicine, 2021 · DOI: https://doi.org/10.1155/2021/3741461 · Published: December 26, 2021

Spinal Cord Injury Surgery Rehabilitation

Simple Explanation

A 17-year-old patient was admitted with quadriplegia following a stab wound to the cervical spine. After physiotherapy, he showed spontaneous neurological improvement. After two weeks, he was able to sit unaided and walked at three months of physiotherapy. The patient's case was unique because of the stabbing mechanism and the subsequent spontaneous neurological improvement with physical therapy rehabilitation. There was no surgical intervention required, and the patient recovered through physical therapy alone. The patient received 30 sessions of physical therapy, each lasting 30 minutes, focusing on muscle stretching, strengthening for elasticity and mobility, and regaining control of his limbs. Pain relievers and empirical antibiotics were also administered.

Study Duration

3 Months

Participants

1 adolescent male

Evidence Level

Level 4, Case Report

Key Findings

1
A patient with neurological deficits secondary to a penetrating spinal injury can completely recover with constant and repeated physiotherapy rehabilitation treatment, especially when there are no other complications.
2
MRI is the modality of choice for evaluating penetrating injuries to the spinal canal in patients with neurological symptoms, as it can reveal contusions, hematomas, and knife-track damage.
3
Surgical intervention is not always necessary for penetrating spinal injuries, even when neurological deficits are present; conservative treatment, such as physiotherapy, can be effective.

Research Summary

This case report describes a 17-year-old patient who recovered from quadriplegia caused by a stab wound to the cervical spine through physiotherapy alone, without surgical intervention. The patient's spontaneous neurological improvement highlights the potential effectiveness of conservative treatment for penetrating spinal injuries, even in the presence of neurological deficits. The case underscores the importance of MRI in evaluating penetrating spinal injuries and suggests that surgery should not be the default approach in all cases, particularly when there are no other complications.

Practical Implications

Conservative Treatment Option

Physiotherapy should be considered as a primary treatment option for penetrating spinal injuries, even when neurological deficits are present, especially when surgical indications are not evident.

Imaging Importance

MRI should be prioritized in the evaluation of penetrating spinal injuries to assess the extent of damage and guide treatment decisions.

Individualized Approach

Management of penetrating spinal injuries should be individualized, considering the specific injury characteristics, neurological status, and the presence of complications, rather than adhering to a mandatory surgical exploration policy.

Study Limitations

1
Single case report limits generalizability
2
Lack of a control group
3
The specific factors contributing to the spontaneous recovery are not fully elucidated

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