Comprehensive treatment of a patient with complicated thoracic spine injury using percutaneous electrical spinal cord stimulation (case report)

Abstract

Objective Demonstrate an outcome of comprehensive treatment of an adolescent with fracture-dislocation of the thoracic spine accompanied by deep lower paraplegia and pelvic floor dysfunction using noninvasive percutaneous spinal cord stimulation and mechanical stimulation of the foot bearing surface. Case study Comprehensive treatment was performed for a 17-year-old patient who sustained a combined injury during roller ski training. The patient presented with back pain, breathing difficulty, being unable to perform active movements of lower extremities. He reported loss of sensitivity in the lower part of the body, perineum and lower limbs. The injury was classified as ASIA grade B with motor impairment scored 50 and overall sensory score of 88. Surgical intervention was produced within the first hours after injury and was followed by rehabilitation program including stimulation of the foot bearing surface with Korvit plantar support load simulator and noninvasive percutaneous spinal cord stimulation. Neurologic status of the patients was graded as ASIA level D at one-year follow-up with motor score of 85 and sensory level improved to 175. Conclusion Surgical treatment produced for the patient with spinal cord injury within the first hours after trauma using noninvasive percutaneous spinal cord stimulation and mechanical stimulation of the foot bearing surface provided regress of neurological disorders facilitating more intense lower-limb motor recovery and other important gait characteristics. The patient could regain voluntary control of muscle activity, stand unassisted and walk with a cane at one year post-injury.