Background
Case presentation
Motor Gr (Rt/Lt) | Sensory Gr (Rt/Lt) | ASIA impairment scale | ||
---|---|---|---|---|
Before first operation | L2, Hip flexors | 5/5 | 2/2 | E |
L3, Knee extensors | 5/5 | 2/2 | ||
L4, Ankle dorsiflexors | 5/5 | 2/2 | ||
L5, Long toe extensiors | 5/5 | 2/2 | ||
S1, Ankle Plantar flexors | 5/5 | 2/2 | ||
After first operation | L2, Hip flexors | 0/0 | 0/0 | A |
L3, Knee extensors | 0/0 | 0/0 | ||
L4, Ankle dorsiflexors | 0/0 | 0/0 | ||
L5, Long toe extensiors | 0/0 | 0/0 | ||
S1, Ankle Plantar flexors | 0/0 | 0/0 | ||
After second operation (1 day) | L2, Hip flexors | 4/4 | 1/1 | D |
L3, Knee extensors | 4/4 | 1/1 | ||
L4, Ankle dorsiflexors | 4/4 | 1/1 | ||
L5, Long toe extensiors | 4/4 | 1/1 | ||
S1, Ankle Plantar flexors | 4/4 | 1/1 | ||
After second operation (14 days) | L2, Hip flexors | 5/5 | 2/2 | E |
L3, Knee extensors | 5/5 | 2/2 | ||
L4, Ankle dorsiflexors | 5/5 | 2/2 | ||
L5, Long toe extensiors | 5/5 | 2/2 | ||
S1, Ankle Plantar flexors | 5/5 | 2/2 |
Discussion and conclusions
Case | Age/Sex | Diagnosis | Treatment | Symptom after first operation | Treatment after first operation | Final outcome |
---|---|---|---|---|---|---|
Chin et al. | 59 / Male | CSM | ACDF C4–5, C5–6 | Incomplete tetraplegia | 1. High-dose steroid protocol 2. C5 corpectomy | Left finger flexion 3/5 Left finger extension and interossei 4/5 Left hip abduction 5−/5 Left quadriceps and hamstring 4/5 Left other muscle groups 2/5 Right lower limb 5/5 |
Giammalva et al. | 64 / Male | CSM | ACDF C3–4, C5–6 | Tetraparesis | 1.High dose steroid protocol | Right hand prehension 3/5 Right arm flexion 2/5 Both leg flexion 2/5 |
Antwi et al. | 68 / Male | CSM | PCDF C3–7 | Hemiparesis (Left) | 1. High-dose steroid protocol | Left wrist flexion 3/5 Left wrist extension 4+/5 Left elbow flexion 4+/5 Left elbow extension 4+/5 Left hip flexion 2+/5 Left knee extesion 4/5 Left ankle dorsiflexion 1/5 Left ankle plantar flexion 2/5 |
Our case | 49 / Female | CSR | ACDF C6–7 | Paraplegia | 1. High-dose steroid protocol 2. Laminoplasty C4–5–6-7 | Both lower limb full strength |