Physical therapy treatment of a pediatric patient with symptoms consistent with a spinal cord injury without radiographic abnormality: A retrospective case report |
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| Affiliation: | 1. Research Physical Therapy Specialists, Columbia, SC, USA;2. American Academy of Manipulative Therapy, Montgomery, AL, USA;3. A Plus Physical Therapy, Livingston, NJ, USA;4. Montgomery Osteopractic Physiotherapy and Acupuncture Clinic, Montgomery, AL, USA;1. Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal;2. University of Southern Santa Catarina (UNISUL), Palhoça, SC, Brazil;3. Postgraduate Program in Public Health, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil;4. PostureLab, Connaissance & Evolution, Paris, France;5. School of Postural and Manual Therapy, Salgado Institute of Integral Health, Londrina, PR, Brazil;6. Centre d’Evaluation et de Traitement de la Douleur (CETD), Centre Hospitalier de Valenciennes (CHV), Valenciennes, France;7. Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Florianópolis, SC, Brazil;1. Master''s Program in Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil;2. Department of Neurology, Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil;3. Department of Applied Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil;1. Federal University of Triangulo Mineiro, Uberaba, MG, Brazil;2. Department of Applied Physiotherapy, Federal University of Triangulo Mineiro, Uberaba, MG, Brazil;1. Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Centre (UNISUAM), Rio de Janeiro, Brazil;2. Department of Medical Imaging, Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria;3. Department of Kinesiotherapy, Faculty of Public Health, Medical University of Sofia, Bulgaria;4. Department of Physical Therapy, School of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil;5. Postgraduate Program in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil;1. Laboratory of Biomechanics, Center of Sports, Federal University of Santa Catarina - Florianópolis, Santa Catarina, Brazil;2. Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul - Porto Alegre, Rio Grande do Sul, Brazil;1. Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland;2. Swiss Specialist Group for Analytical Biomachenaics According to Sohier, Switzerland;3. Regional Hospital Baselland-Bruderholz, Institute for Radiology and Nuclear Medicine, Switzerland |
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| Abstract: | BackgroundA spinal cord injury without radiographic abnormality (SCIWORA) is a relatively uncommon event that occurs in children following cervical trauma primarily due to sports-related injuries or physical abuse.Case descriptionThis case report describes an 11-year-old wrestler that developed signs and symptoms consistent with a SCIWORA following neck trauma during competition. Despite all diagnostic tests being inconclusive, the patient demonstrated increased cervical, thoracic, and lumbar paraspinal tone along with pain, loss of sensation, loss of mobility, and weakness of the lower extremities. As a result, the patient was confined to a wheelchair and required maximum assistance to transfer and ambulate with a walker. The patient was referred to physical therapy nine days after the traumatic event, where he received interferential current with moist heat, myofascial release of paraspinal muscles, functional exercise, gait training, and spinal manipulative therapy targeting the cervical, thoracic, and lumbar vertebrae.OutcomeAfter 13 physical therapy treatments over 5-weeks, the patient was able to ambulate independently and perform all activities of daily living without pain or functional limitation. The following case report outlines this patient's successful journey toward recovery.ConclusionThis case report suggests that spinal manipulative therapy may be a safe and effective intervention when used within a multi-modal treatment strategy for patients with signs and symptoms consistent with SCIWORA. Moreover, spinal manipulative therapy may be considered a beneficial treatment in some pediatric patients. However, this report describes a single patient, and further research is required on the use of spinal manipulation in this patient population. |
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| Keywords: | Manipulation Osteopathic Pediatric Spinal cord injury |
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