Complex clinical and therapeutic rehabilitation approach of a patient with complete AIS/Frankel A tetraplegia post cervical spinal cord injury after accidental fall off a trailer and multiple complications occurring during disease progression - case study

Abstract

Introduction: Spinal cord injury is a complex neurologic condition that embeds multiple complications, which are often debilitating for patients as the disease progresses. Materials and Methods: This paper presents a case of a 44-year-old patient with a longilin asthenic constitution and no previous medical history, who accidentally fell off a trailer resulting in burst fracture dislocation of C6/C7 associated with immediate loss and consciousness and onset of complete ASIA-A tetraplegia with C5 neurologic level. The patient received a complex nursing program, which included extensive debridement of the necrotic tissue, daily antiseptic wound dressing using Chloramine solution and silver sulfadiazine cream along with wide-spectrum antibiotic therapy with slow but favorable progression. During hospitalization the patient developed an episode of respiratory distress which responded favorably to Levocetirizine daily. Results: The complex neuro-muscular rehabilitation program along with the medical treatment and surgical debridement the patient received have improved of the clinical outcome with the shrinkage of the pressure point lesions, adequate respiratory function which permitted the mobilization of the patient with the wheelchair. Conclusions: Patients with spinal cord injuries are prone to a vast majority of complications including pressure sores complicated with necrotizing fasciitis and respiratory distress that could alter the quality of life. Proper monitoring and management of these kind of complications in the context of neuromuscular rehabilitation are necessary for the enhancement of the quality of life. Key words: spinal cord injury, tetraplegia, complications,