Medical-rehabilitation endeavors, care interventions and connotations of a medical-social type, in a complex polypathological case: paraplegia, spondylodiscitis, kidney failure in the haemodialysis stage, and bilateral nephrostomies post operated bladder neoplasm

Abstract

Abstract Introduction Paraplegia or paralysis of lower extremities is caused mainly by disorders of the spinal cord and cauda equina. They are classified as traumatic and non traumatic. Non traumatic paraplegia has multiple causes such as cancer, infection, intervertebral disc disease, vertebral injury and spinal cord vascular disease. The current case report presents the case of a male patients with paraplegia related to the thoracic spondylodiscitis in a patient on haemodialysis. Material and method. Having the patient’s consent and The Teaching Emergency Hospital “Bagdasar-Arseni” Ethics Committee’s approval, N.O. 17464/14.06.2019, a 72 years old patient, which known with operated bladder neoplasm (2015-neobladder), Chronic kidney failure in haemodialysis program and spondylodiscitis T10-T11 operated in 29.12.2018. Results and discussions. The patient improved on most of the assessment scales/scores implemented in our clinic’s Division Motor FIM ( Functional İndependence Measure) from 43/91 to 54/91,AIS (American Spinal Injury Association Impairment Scale) from 85/100 motor to 92/100. Conclusions. İnfectious diseases are important causes of non-traumatic paraplegia. The risk of infection on haemodialysis patient is further increased because of frequent routine skin penetration for venipuncture and operative procedures such as placement of venous catheters and vascular grafts. Key words: paraplegia, haemodialysis, spondylodiscitis, neoplasm, nephrostomy,