Rehabilitation and clinical-evolutive aspects in a case of paraparesis after multilevel lumbar disc herniation, spinal canal stenosis and spondylolisthesis iteratively operated, in a pluripathological context

Abstract

Introduction. Disc herniation occurs most commonly in the lumbar region (95% of the cases). The current trend is to have surgery on patients with disc herniation if the kinetic treatment was not beneficial. The data from the literature suggest that early active recovery after lumbar disc herniation is more beneficial than a traditional, less active training program. Material and method. Having the patient's consent and the approval of the Ethics Committee of “Bagdasar-Arseni” Clinical Emergency Hospital, N.O. 17464 / 14.06.2019, the paper presents the case of a 75-year-old patient with paraparesis after multilevel lumbar disc herniation, spinal canal stenosis and spondylolisthesis iteratively operated, in pluripathological context (hyperplastic type II obesity, hypertension, prostate adenocarcinoma operated in 2015, Clostridium enterocolitis). The patient was clinically and functionally evaluated, according to the standardized protocols implemented in our clinic, through the assessment scales (ASIA, FIM, FAC, QoL, Ashworth and Penn) and also paraclinically, in order to evaluate his biological reserve and his bearing availability of the recovery program. Results and discussions. The patient presented a slowly favorable evolution (slowed down not only by his multiple above-mentioned comorbidities) from a dysfunctional point of view. Conclusions. Early active recovery after lumbar disc herniation surgery is more beneficial than a traditional, less active training program for operated herniated discs. Keywords: Schizophrenia, spinal cord injury, multidisciplinary, suicide attempt, rehabilitation,