Rehabilitation of a patient with spinal cord lesion due to surgical removal of the spinal tumor with chronic idiopathic demyelinating polyneuropathy (CIDP): A case report

Abstract

Aims: The literature provides numerous medical therapies for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and spinal cord lesion following spinal tumor surgery separately. Spinal cord injuries from CIDP-related spinal tumors have no evidence-based rehabilitation methods. This case report discusses CIDP, spinal cord lesion owing to a spine tumor, and tertiary care interdisciplinary rehabilitation. It shows how medical knowledge, clinical reasoning, and evidence guide outcome measures, care plans, and clinical decisions help to overcome CIDP. Methods: In this report, we follow a 27-year-old male who began experiencing gradual paresthesia and mild weakening in his lower extremities for six weeks. After two months, the lumbar spine had the initial operation (laminectomy) because of the extreme pain. After the operation, he was pain-free, able to walk, and even started riding again. Pain in his lower midback, similar to cramping, and moderate swelling in his left ankle forced him into a wheelchair three years after his initial operation (intradural-extramedullary spinal space-occupying lesion at L2–L5 level). After the second operation (laminectomy), he had trouble in walking, lost sensation below the knees on both legs, and experienced mild incontinence. As the patient was confined to a wheelchair, he was standing with the help of two people. Significant main muscle group weakening was one of the first noticeable symptoms. Therapeutic exercise, balance training, functional training, and progressive endurance activities were the main components of the intervention. Berg balance score increased from 5 to 23, which is an eligible score for discharge. Results: Clinical outcomes for the man with spinal cord lesion and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) were improved with interdisciplinary therapy. The patient underwent a first lumbar spine operation, which initially eased pain and allowed him to walk and ride again after feeling gradual paresthesia and minor weakened in his lower extremities. Conclusion: For this patient with CIDP with spinal cord lesion due to spinal tumor, effective collaborative team communication and interdisciplinary management worked to optimize clinical decision making and recovery.